Individual provider Active NPI

Sharon Anna Shaji

  • Physician Assistant
  • Sunnyvale, TX
National Provider Identifier
1427886456
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA18152 Issued in TX
Practice address
3107 Caddo LN
Sunnyvale, TX 75182-4036
Phone
(267) 516-2105
NPI assigned
Jul 22, 2024
Last updated
Jul 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 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 PA18152 TX Primary

Addresses

Primary practice location

3107 Caddo LN
Sunnyvale, TX 75182-4036

Mailing address

3107 Caddo LN
Sunnyvale, TX 75182-4036
Phone (267) 516-2105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20241023004476 TX Practitioner - Physician Assistant 1759814163 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Pain Centers PAGroup PAC ID 8426312646, 12 clinicians

Practice addresses (Care Compare)

1323 E Franklin St
Suite 102
Hillsboro, TX 76645-2679
Phone (469) 562-4188

403 W Campbell Rd
Suite 305
Richardson, TX 75080-3468
Phone (469) 562-4188

7904 NE Loop
820 Suite C
North Richland Hills, TX 76180-7395
Phone (469) 562-4188

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA18152TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Our Family Doctor, P. a. Past Accepting new patients

Organizations & group practices 2

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": "1721606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1427886456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3107 CADDO LN",
            "city": "SUNNYVALE",
            "state": "TX",
            "postal_code": "751824036",
            "telephone_number": "267-516-2105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3107 CADDO LN",
            "city": "SUNNYVALE",
            "state": "TX",
            "postal_code": "751824036",
            "telephone_number": "267-516-2105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAJI",
        "first_name": "SHARON",
        "middle_name": "ANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-07-22",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA18152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyvale, TX

Sources for this page

Verify at the official NPI Registry.