Individual provider Active NPI

Samar El-Sharkawy

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1255808580
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7470 Issued in AZ
Practice address
1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone
(602) 933-4063
Fax
(602) 933-2423
NPI assigned
Oct 24, 2018
Last updated
Apr 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 7470 AZ Primary

Addresses

Primary practice location

1919 E Thomas Rd
Phoenix, AZ 85016-7710

Mailing address

2108 E Thomas Rd Ste 130
Phoenix, AZ 85016-0008
Phone (602) 933-3124

Other practice location 1

7301 E 2nd St
Scottsdale, AZ 85251-5600
Phone (480) 882-4545

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190710002247 AZ Practitioner - Physician Assistant 0941535132 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
7470AZMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Outreach Access to Health CurrentSince Jun 10, 2019 Accepting new patients
Phoenix Children's Medical Group CurrentSince Jan 1, 2024 Accepting new patients
Phoenix Children's Medical Group CurrentSince Jan 1, 2024 Accepting new patients
Neighborhood Outreach Access to Health CurrentSince Jun 10, 2019 Accepting new patients
Valley Anesthesiology Consultants, Inc. PastSince Mar 1, 2020 Accepting new patients

Locations

1665 N Avondale Blvd
Avondale, AZ 85392
Phone (602) 933-0005

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

20440 N 27th Ave
Phoenix, AZ 85027

2108 E Thomas Rd
Ste 130
Phoenix, AZ 85016

4131 N 24th St
Ste B102
Phoenix, AZ 85016
Phone (602) 955-6632

7301 E 2nd St
Ste 210
Scottsdale, AZ 85251
Phone (480) 534-4515

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1540339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1255808580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 E THOMAS RD STE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850160008",
            "telephone_number": "602-933-3124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-933-4063",
            "fax_number": "602-933-2423"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7301 E 2nd St",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852515600",
            "country_code": "US",
            "telephone_number": "480-882-4545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EL-SHARKAWY",
        "first_name": "SAMAR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-24",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "7470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.