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ETHAN SHAKEEL JEFFERSON PA-C
NPI 1275358806
Family Medicine in Grass Valley, CA

Active since November 19, 2024PECOS Enrolled
280 SIERRA COLLEGE DR STE 207, GRASS VALLEY, CA 95945(530) 477-7390(530) 477-7389 Get Directions Write a Review

NPPES record last updated: December 3, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 3, 2025, Nov 19, 2024 (2 updates tracked since 2024).

About Ethan Shakeel Jefferson Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETHAN SHAKEEL JEFFERSON PA-C (NPI 1275358806) is an individual family medicine provider in Grass Valley, California, licensed in California (67370) and active in the NPI registry since November 2024. He is enrolled in Medicare PECOS and is a graduate of University Of California, Davis School Of Medicine (2025).

NPPES Registry Identity

NPI1275358806
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameETHAN SHAKEEL JEFFERSONCredential: PA-C
Location Address280 SIERRA COLLEGE DR STE 207Grass Valley, CA 95945-5769
Mailing Address2725 I St Apt 2Sacramento, CA 95816-4367 · (530) 615-1615
Phone(530) 477-7390
Fax(530) 477-7389
Sole ProprietorNo
Medical School CMSUniversity Of California, Davis School Of MedicineGraduated 2025
Enumeration DateNovember 19, 2024
Last NPPES UpdateDecember 3, 20252 updates tracked since enumeration
NPPES CertifiedDecember 3, 2025
✔ NPI 1275358806 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CA · 67370
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
280 SIERRA COLLEGE DR STE 207, Grass Valley, CA 95945
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ethan Shakeel Jefferson Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9830679778
PECOS Enrollment IDI20260218002328
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95945 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.32 typical visit price
range $58.87 – $176.60
Typical copayment $22.58 (range $14.71 – $44.15)
Most-billed visit code 99203
Established Patient
$103.36 typical visit price
range $19.28 – $144.60
Typical copayment $25.84 (range $4.82 – $36.15)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. TODD BOUCHIER MD
Family Medicine
280 SIERRA COLLEGE DR STE 207
GRASS VALLEY, CA 95945
Nevada County (530) 477-7390
BOUCHIER-PRITCHETT FAMILY MEDICINE PC
Family Medicine
280 SIERRA COLLEGE DR STE 207
GRASS VALLEY, CA 95945
Nevada County (530) 477-7390

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethan Jefferson's NPI number?

The NPI number for Ethan Jefferson is 1275358806. It was assigned to this individual provider in the NPPES registry on November 19, 2024.

Where is Ethan Jefferson located?

Ethan Jefferson practices at 280 Sierra College Dr Ste 207, Grass Valley, CA 95945. The listed phone number is (530) 477-7390.

What is Ethan Jefferson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Ethan Jefferson enrolled in Medicare?

Yes. Ethan Jefferson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Ethan Jefferson was last updated on December 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.