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KRISTA SHAMBAUGH PMHNP
NPI 1720538788
Nurse Practitioner - Psychiatric/Mental Health in San Diego, CA

Active since October 13, 2016PECOS Enrolled
4060 FAIRMOUNT AVE, SAN DIEGO, CA 92105(619) 280-4213 Get Directions Write a Review

NPPES record last updated: October 9, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 9, 2024, Aug 19, 2024, Jul 14, 2020 and 1 more (4 updates tracked since 2016).

About Krista Shambaugh Pmhnp NPPES

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

KRISTA SHAMBAUGH PMHNP (NPI 1720538788) is an individual psychiatric/mental health provider in San Diego, California, licensed in California (95031769) and active in the NPI registry since October 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1720538788
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameKRISTA SHAMBAUGHCredential: PMHNP
Location Address4060 FAIRMOUNT AVESan Diego, CA 92105-1608
Mailing Address4060 Fairmount AveSan Diego, CA 92105-1608 · (619) 280-4213
Phone(619) 280-4213
Sole ProprietorYes
Enumeration DateOctober 13, 2016
Last NPPES UpdateOctober 9, 20244 updates tracked since enumeration
NPPES CertifiedSeptember 9, 2024
✔ NPI 1720538788 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in CA · 95031769
Also ListedRegistered Nurse · Community HealthTaxonomy 163WC1500X · License 95097866 (CA)
Also ListedRegistered Nurse · Psychiatric/Mental Health, AdultTaxonomy 163WP0809X · License 95097866 (CA)
4060 FAIRMOUNT AVE, San Diego, CA 92105
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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)

Krista Shambaugh Pmhnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 92105 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
$94.87 typical visit price
range $62.10 – $184.71
Typical copayment $23.71 (range $15.52 – $46.17)
Most-billed visit code 99203
Established Patient
$108.42 typical visit price
range $20.62 – $151.42
Typical copayment $27.10 (range $5.15 – $37.85)
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 20

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

DR. DORA DOAN O.D.
Optometrist
4060 FAIRMOUNT AVE, OPTOMETRY DEPARTMENT
SAN DIEGO, CA 92105
San Diego County (619) 961-0803
DIANA P ALVAREZ MSW
Counselor (Mental Health)
4060 FAIRMOUNT AVE
SAN DIEGO, CA 92105
San Diego County (619) 295-6047
KALEELAH RAE, NAJA MUHAMMAD
Student in an Organized Health Care Education/Training Program
4060 FAIRMOUNT AVE
SAN DIEGO, CA 92105
San Diego County (619) 280-4213
DR. ADLA TESSIER M.D.
Internal Medicine
4060 FAIRMOUNT AVE, FAMILY PRACTICE
SAN DIEGO, CA 92105
San Diego County (619) 255-9155
CYNTHIA MIRANDA PSYD
Psychologist
4060 FAIRMOUNT AVE
SAN DIEGO, CA 92105
San Diego County (619) 564-8765
TONYA DANIELLE DANIEL LCSW
Social Worker (Clinical)
4060 FAIRMOUNT AVE
SAN DIEGO, CA 92105
San Diego County (619) 584-1612
SAMANTHA GOGGIN MD
Pediatrics
4060 FAIRMOUNT AVE, PEDIATRICS DEPARTMENT
SAN DIEGO, CA 92105
San Diego County (619) 255-9154
NYAKOACH LAM ACSW
Social Worker
4060 FAIRMOUNT AVE
SAN DIEGO, CA 92105
San Diego County (619) 285-7097

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 Krista Shambaugh's NPI number?

The NPI number for Krista Shambaugh is 1720538788. It was assigned to this individual provider in the NPPES registry on October 13, 2016.

Where is Krista Shambaugh located?

Krista Shambaugh practices at 4060 Fairmount Ave, San Diego, CA 92105. The listed phone number is (619) 280-4213.

What is Krista Shambaugh's specialty?

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

Is Krista Shambaugh enrolled in Medicare?

Yes. Krista Shambaugh is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Krista Shambaugh was last updated on October 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.