Active NPI
John J Shaff, PA-C
- Physician Assistant
- Phoenix, AZ
National Provider Identifier
1114084316
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 3149
- Practice address
- 16611 S. 40TH St
Suite 100
Phoenix, AZ 85048 - Phone
- (480) 610-6366
- Fax
- (480) 833-1653
- NPI assigned
- Jan 3, 2007
- Last updated
- Apr 22, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 3149 | AZ | Primary |
Addresses
Primary practice location
16611 S. 40TH St
Suite 100
Phoenix, AZ 85048
Mailing address
16611 S. 40TH St
Suite 100
Phoenix, AZ 85048
Phone (480) 610-6366
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3Z3955 | Other | AZ | HEALTHNET |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3149 | AZ | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arizona College of Orthopedic Surgeons, PLLC | Past | Accepting new patients |
Interoperability endpoints
- johnshaff@ad.allscriptsdirect.net
- jshaff@directaddress.net
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Orthopaedic Surgery Physician
- Avondale, AZ
- NPI 1225190820
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587513600000",
"number": "1114084316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16611 S. 40TH ST",
"address_2": "SUITE 100",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85048",
"telephone_number": "480-610-6366",
"fax_number": "480-833-1653"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16611 S. 40TH ST",
"address_2": "SUITE 100",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85048",
"telephone_number": "480-610-6366",
"fax_number": "480-833-1653"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAFF",
"first_name": "JOHN",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-03",
"last_updated": "2020-04-22",
"certification_date": "2020-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "3149",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET",
"identifier": "3Z3955",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.