Shantala Mask, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

2911 Issued in AZ

Practice address

4136 N 75TH Ave
Ste. 101
Phoenix, AZ 85033-3171

Phone

(623) 849-2220

Fax

(623) 849-2574

NPI assigned

Jul 28, 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Buckeye Pediatrics, LLC

  • Pediatrics Physician
  • Buckeye, AZ
  • NPI 1932498763
  NPD (past)
• Northwest Cloinic for Children

  • Pediatrics Physician
  • Phoenix, AZ
  • NPI 1083815666
  NPD (past)

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391472000000",
    "number": "1336304427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4136 N 75TH AVE",
            "address_2": "STE. 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850333171",
            "telephone_number": "623-849-2220",
            "fax_number": "623-849-2574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4136 N 75TH AVE",
            "address_2": "STE. 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850333171",
            "telephone_number": "623-849-2220",
            "fax_number": "623-849-2574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASK",
        "first_name": "SHANTALA",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-28",
        "last_updated": "2014-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "2911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT  LICENSE",
            "identifier": "2911",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debbie Sunshine Mascovich, PAC
• Carole Anne Maselli, LPN
• Catheryn D Masferrer, LMSW
• Swan Ann Mashatisa, RN
• Anas Mashlah
• Dahlia C Maskin, P.A.-C.
• Erik Maskin, D.O
• John E Maslak, DDS
• Darlene Mason-Lopez, MT
• Ann Michelle Mason, PHARMD

• Medical Physician Assistant in Phoenix, AZ
• Providers in Phoenix, 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 Feb 4, 2014; 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.