Nicole Warner Shaha, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

6826 Issued in AZ

Practice address

2545 E Intrepid Ave
Mesa, AZ 85204-7028

Phone

(208) 716-2350

NPI assigned

Aug 7, 2017

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

Other identifiers 1

Other names 1

• Nicole Warner Former name

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

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Arizona Spine and Joint Hospital Hospital, Mesa, AZ, CCN 030107

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nicoleshaha@asjh.medalliesdirect.net

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.

• Nwse: Nicole Warner Shaha Enterprises, LLC

  • Surgical Physician Assistant
  • Mesa, AZ
  • NPI 1205663846

  Single Specialty

  NPD Authorized official
• Arizona Progressive Medical Centers

  • Chiropractor
  • Phoenix, AZ
  • NPI 1356689772

  Single Specialty

  NPD
• Arizona Spine and Joint Hospital LLC

  • General Acute Care Hospital
  • Mesa, AZ
  • NPI 1396745832

  Single Specialty

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Arizona Spine and Joint Hospital LLC

  • General Acute Care Hospital
  • Mesa, AZ
  • NPI 1396745832
  Care Compare affiliation

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

{
    "created_epoch": "1502064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1477078764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2545 E INTREPID AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852047028",
            "telephone_number": "208-716-2350",
            "fax_number": "480-378-2279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 E INTREPID AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852047028",
            "telephone_number": "208-716-2350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHA",
        "first_name": "NICOLE",
        "middle_name": "WARNER",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-07",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "6826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477078764",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "WARNER",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kunjan Shah, M.D.
• Mikulkumar D Shah, MD
• Prakash Shantilal Shah, MD
• Ruchit Shah
• Sanjay J Shah, MD
• Mahmood R Shahlapour, M.D.
• Robert S Shahon, MD
• Arfa Shaik
• Furqaan Shaikh
• Shalom Heritage LLC- Hope Home

• Surgical Physician Assistant in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Surgical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.

Verify at the official NPI Registry.