Active NPI
Julietta Rachel Shapiro, PA-C
- Physician Assistant
- Phoenix, AZ
National Provider Identifier
1356824114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 7171
- Practice address
- 20950 N Tatum Blvd Ste 190
Phoenix, AZ 85050-4251 - Phone
- (602) 776-0021
- Fax
- (623) 742-2061
- NPI assigned
- Sep 7, 2018
- Last updated
- Feb 15, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 60912915 | WA | |
| Physician Assistant | 363A00000X | 7171 | AZ | Primary |
| Physician Assistant | 363A00000X | AZ |
Addresses
Primary practice location
20950 N Tatum Blvd Ste 190
Phoenix, AZ 85050-4251
Mailing address
20950 N Tatum Blvd Ste 190
Phoenix, AZ 85050-4251
Phone (480) 776-0021
Other practice location 1
903 S Adams St
Ritzville, WA 99169
Phone (509) 659-1200
Other practice location 2
903 S Adams St
Ritzville, WA 99169
Phone (509) 659-1200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154378 | Medicaid | AZ |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
14541 W Indian School Rd
Suite 600
Goodyear, AZ 85395-9243
Phone (888) 698-6727
4712 E Rose Garden LN
Phoenix, AZ 85050-4264
Phone (602) 755-0800
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60912915 | WA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Glendale Medical Clinic LLC | Past | Accepting new patients |
Interoperability endpoints
- jshapiro687165@direct.multicare.org
- julietta.shapiro.1@19654.direct.athenahealth.com
- julietta.shapiro.1@22605.direct.athenahealth.com
- julietta.shapiro.p1@direct.nextcare.nextgenshare.com
- julietta.shapiro.p1@direct.ritzville.nextgenshare.com
Organizations & group practices 5
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.
-
- Family Medicine Physician
- Glendale, AZ
- NPI 1053810622
-
- Physician Assistant
- Glendale, AZ
- NPI 1205435880
-
- Urgent Care Clinic/Center
- Tempe, AZ
- NPI 1114798071
-
- Urgent Care Clinic/Center
- Glendale, AZ
- NPI 1952887655
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707955200000",
"number": "1356824114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20950 N TATUM BLVD STE 190",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850504251",
"telephone_number": "480-776-0021",
"fax_number": "623-742-2061"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20950 N TATUM BLVD STE 190",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850504251",
"telephone_number": "602-776-0021",
"fax_number": "623-742-2061"
}
],
"practiceLocations": [
{
"address_1": "903 S Adams St",
"address_purpose": "LOCATION",
"city": "Ritzville",
"state": "WA",
"postal_code": "99169",
"country_code": "US",
"telephone_number": "509-659-1200",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "903 S Adams St",
"address_purpose": "LOCATION",
"city": "Ritzville",
"state": "WA",
"postal_code": "99169",
"country_code": "US",
"telephone_number": "509-659-1200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHAPIRO",
"first_name": "JULIETTA",
"middle_name": "RACHEL",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-07",
"last_updated": "2024-02-15",
"certification_date": "2024-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WA",
"license": "60912915",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "7171",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1154378",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; 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.