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MR. SHAUN MARVIN LUTHER PMHNP-BC
NPI 1497522072
Nurse Practitioner - Psychiatric/Mental Health in Stockton, CA

Active since December 05, 2023PECOS EnrolledAccepts Medicare Assignment
776 W LONGVIEW AVE, STOCKTON, CA 95207(951) 215-8465 Get Directions Write a Review

NPPES record last updated: May 7, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 7, 2025, Dec 5, 2023 (2 updates tracked since 2023).

About Mr. Shaun Marvin Luther Pmhnp-bc NPPES

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

MR. SHAUN MARVIN LUTHER PMHNP-BC (NPI 1497522072) is an individual psychiatric/mental health provider in Stockton, California, licensed in California (95034866) and active in the NPI registry since December 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1497522072
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameMR. SHAUN MARVIN LUTHERCredential: PMHNP-BC
Location Address776 W LONGVIEW AVEStockton, CA 95207-4713
Mailing Address776 W Longview AveStockton, CA 95207-4713 · (951) 215-8465
Phone(951) 215-8465
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateDecember 5, 2023
Last NPPES UpdateMay 7, 20252 updates tracked since enumeration
NPPES CertifiedMay 7, 2025
✔ NPI 1497522072 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in CA · 95034866
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License 814023 (CA)
776 W LONGVIEW AVE, Stockton, CA 95207
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Shaun Marvin Luther Pmhnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4486151933
PECOS Enrollment IDI20251009002528
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Shaun Luther reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mind Body Medicine Inc
1.2 mi
Psychiatry
1811 GRAND CANAL BLVD STE 3
Stockton, CA 95207
  • Reassigned Medicare billing, California enrollment
  • 12 clinicians in this Medicare group
NPI 1871278754 (209) 800-1718
Memory Check Psychological Services, A Professional Corporation
406 mi
Clinical
1902 WRIGHT PL FL CENTER2
Carlsbad, CA 92008
  • Reassigned Medicare billing, California enrollment
  • 223 clinicians in this Medicare group
NPI 1912184219 (888) 515-3834

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95207 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.

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 Shaun Luther's NPI number?

The NPI number for Shaun Luther is 1497522072. It was assigned to this individual provider in the NPPES registry on December 5, 2023.

Where is Shaun Luther located?

Shaun Luther practices at 776 W Longview Ave, Stockton, CA 95207. The listed phone number is (951) 215-8465.

What is Shaun Luther's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Shaun Luther enrolled in Medicare?

Yes. Shaun Luther is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Shaun Luther's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shaun Luther reassigns Medicare benefits to 2 organizations: Mind Body Medicine Inc (Stockton, CA) and Memory Check Psychological Services, A Professional Corporation (Carlsbad, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shaun Luther's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Shaun Luther was last updated on May 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.