Shadia Sarah Tolliver, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

126912 Issued in AK

Practice address

2741 Debarr Rd Ste 307
Anchorage, AK 99508-2972

Phone

(907) 777-1850

Fax

(855) 468-1357

NPI assigned

May 17, 2016

Last updated

Jan 2, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Shadije Sadiku Former name

Medicare fee-for-service enrollment

Enrolled in AK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arete Family Care LLCGroup PAC ID 0446653117, 11 clinicians

Ophthalmic Associates a Professional CorporationGroup PAC ID 4183515596, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9493/brand/2/csg/1/fhir/r4
• Direct secure messaging: shadia.tolliver.1@24116.direct.athenahealth.com
• Direct secure messaging: shadia.tolliverpac.p1@direct.ophthalmicassociates.nextgenshare.com

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.

• Arete Family Care LLC

  • Family Medicine Physician
  • Anchorage, AK
  • NPI 1801460415
  Medicare reassignment Care Compare group
• Ophthalmic Associates a Professional Corporation

  • Ophthalmology Physician
  • Anchorage, AK
  • NPI 1255325692
  Medicare reassignment Care Compare group
• Alaska Family Care Associates, LLC

  • Family Medicine Physician
  • Anchorage, AK
  • NPI 1013025600
  Medicare reassignment
• Providence Health & Services- Washington

  dba Providence Medical Group Alaska

  • Critical Care Medicine (Internal Medicine) Physician
  • Anchorage, AK
  • NPI 1093956278
  Medicare reassignment
• Urgent Care at Lake Lucille Inc

  • Urgent Care Clinic/Center
  • Wasilla, AK
  • NPI 1275587768
  Medicare reassignment
• Alaska Center for Pediatrics, LLC

  • Multi-Specialty Clinic/Center
  • Anchorage, AK
  • NPI 1659581635
  NPD
• Providence Health & Services-Washington

  dba Providence Medical Group Alaska

  • Community/Behavioral Health Agency
  • Anchorage, AK
  • NPI 1841814795
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1463443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1144677402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2741 DEBARR RD STE 307",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082972",
            "telephone_number": "907-777-1850",
            "fax_number": "855-468-1357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2741 DEBARR RD STE 307",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082972",
            "telephone_number": "907-777-1850",
            "fax_number": "855-468-1357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLLIVER",
        "first_name": "SHADIA",
        "middle_name": "SARAH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-17",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "126912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144677402",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHADIJE",
            "last_name": "SADIKU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Meeia Ryneh Tolentino
• Yvonne Tolentino, BSPT,CNA
• Debra Ann Tolliver, LPC, CDCI
• Hunter Jo Tolliver, DDS
• Leslie Tolliver II, PA-C
• Patsyeve Tololi
• Catherine Tomaszewski
• Kristin B Tomaszewsky, OTR/L
• Eric Rodney Tompkins, MD
• Tina R Tomsen, MD

• Physician Assistant in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Physician Assistant in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.