Celeste Edoria Sta Ana, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA2636 Issued in NV

Practice address

10950 S Eastern Ave Ste 100
Henderson, NV 89052-4971

Phone

(702) 614-2191

Fax

(702) 614-2190

NPI assigned

May 11, 2022

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hesham Sirsy MD LTD

  • Pediatrics Physician
  • Henderson, NV
  • NPI 1982763108

  Single Specialty

  NPD

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

{
    "created_epoch": "1652227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1285370320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10950 S EASTERN AVE STE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524971",
            "telephone_number": "702-614-2192",
            "fax_number": "702-614-2190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10950 S EASTERN AVE STE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524971",
            "telephone_number": "702-614-2191",
            "fax_number": "702-614-2190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STA ANA",
        "first_name": "CELESTE",
        "middle_name": "EDORIA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-11",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA2636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St Rose Medical Supplies
• St. Agatha Comfort Care LLC
• Nicolas St. Clair
• St. Rose Family & Cosmetic Dentistry
• St.Agatha Home Health LLC
• Diane Marie Stacey, D.D.S., M.S.
• Douglas S Stacey, DPM
• Michelle L. Stacey, MD
• Julianne Stack
• Danita Stafford, PROFESSIONAL

• All providers in Henderson, NV
• Medical Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2022; 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.