SHELLEY R HASSELMAN, NP — NPI 1003126129 (Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Primary Care in LAKE ARROWHEAD, CA)

CMS-1500 Box 24J / 33a • NPI

1003126129

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

363LP2300X (CMS 50)

Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Primary Care

Box 32 Service Location & ZIP+4

29099 HOSPITAL ROAD, SUITE 204B, LAKE ARROWHEAD, CA, 92352

Official NPPES Practice Location

Practice Phone & Referral Fax

(909) 337-7771

Fax: (909) 337-5353

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1003126129 (SHELLEY R HASSELMAN, NP) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1003126129` (NPI-1 Individual Practitioner)
Provider / Legal Name	SHELLEY R HASSELMAN, NP
Plain-English Specialty	Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Primary Care NUCC Code: `363LP2300X` (Nurse Practitioner, Primary Care)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	29099 HOSPITAL ROAD, SUITE 204B, LAKE ARROWHEAD, CA, 92352
Practice Telephone / Fax	Tel: (909) 337-7771 \| Fax: (909) 337-5353
Administrative Mailing Address	PO BOX 2482, RUNNING SPRINGS, CA, 92382-2482
Enumeration & Last Sync	Enumerated: 2010-10-08 \| CMS Record Updated: 2010-10-08

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

29099 HOSPITAL ROAD, SUITE 204B, LAKE ARROWHEAD, CA, 92352

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Plain-English Taxonomy & CMS Crosswalk (363LP2300X)

What Does Taxonomy Code 363LP2300X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LP2300X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Primary Care"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 50 (Nurse Practitioner)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Nurse Practitioner, Primary Care for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (SHELLEY R HASSELMAN, NP)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`163W00000X` — Registered Nurse Plain English: Licensed & Credentialed Registered Nurse	State: CA \| License: `626568` \| Primary: Secondary
`363LP2300X` — Nurse Practitioner, Primary Care Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Primary Care	State: CA \| License: `20149` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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SHELLEY R HASSELMAN, NP (NPI #1003126129)