Mary Ann Shostek, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

3103 Issued in AZ

Practice address

2152 S Vineyard Ste 138
Mesa, AZ 85210-6882

Phone

(480) 539-6646

Fax

(480) 539-6696

NPI assigned

Jun 6, 2008

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212969600000",
    "number": "1194984823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2152 S VINEYARD STE 138",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852106882",
            "telephone_number": "480-539-6646",
            "fax_number": "480-539-6696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2152 S VINEYARD STE 138",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852106882",
            "telephone_number": "480-539-6646",
            "fax_number": "480-539-6696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOSTEK",
        "first_name": "MARY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-06",
        "last_updated": "2008-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "3103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy Lyn Shontz-Buttery, PHARMD
• Evan Short
• Jessica Short
• Emily Rose Shortridge
• Shosamana
• Alicia Marie Shoup, PT
• Brianne Rae Showman, PT, DPT
• Zhanna F Shpitalnik, MD
• SHPS PLLC
• Eric Otto Shreder, D.O.

• Medical Physician Assistant in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.