NPIMap

Organization Active NPI

Onesource Senior Healthcare PLLC

Doing business as OneSource Mobile Healthcare PLLC

  • Podiatrist
  • Scottsdale, AZ
National Provider Identifier
1508272188
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
ONESOURCE SENIOR HEALTHCARE PLLC
Doing business as
OneSource Mobile Healthcare PLLC
Practice address
16427 N Scottsdale Rd Ste 410
Scottsdale, AZ 85254-7102
Phone
(888) 495-4489
Fax
(602) 865-8090
NPI assigned
Jul 3, 2014
Last updated
Jul 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Phdra Shaba, ODNPI 1689803926
Title
Owner
Phone
(888) 495-4489

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X Primary
AudiologistGroup: 193200000X MULTI-SPECIALTY GROUP 231H00000X

Addresses

Primary practice location

16427 N Scottsdale Rd Ste 410
Scottsdale, AZ 85254-7102

Mailing address

14050 N 83Rd Ave Ste 290
Peoria, AZ 85381-5650
Phone (888) 495-4489

Other practice location 1

16427 N Scottsdale Rd Ste 410
Scottsdale, AZ 85254-7102
Phone (888) 495-4489

Other identifiers 1

IdentifierTypeStateIssuer
944102MedicaidAZ

Other names 1

  • OneSource Mobile Healthcare PLLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, NV, TX, UT4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20140926000777 AZ Part B Supplier - Clinic/Group Practice 6901026988 Receives reassigned benefits from 21 practitioners
Practice locations: Scottsdale, AZ
O20180109001482 NV Part B Supplier - Clinic/Group Practice 6901026988 Receives reassigned benefits from 7 practitioners
Practice locations: Las Vegas, NV
O20250828004517 TX Part B Supplier - Clinic/Group Practice 6901026988 Receives reassigned benefits from 1 practitioner
Practice locations: Dallas, TX
O20251003000828 UT Part B Supplier - Clinic/Group Practice 6901026988 Receives reassigned benefits from 1 practitioner
Practice locations: Draper, UT

National Provider Directory

National Provider Directory
Tax ID family
One Source Mobile Healthcare PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

16427 N Scottsdale Rd
Scottsdale, AZ 85254
Phone (480) 429-2825

7620 E McKellips Rd
Ste 4
Scottsdale, AZ 85257

4933 W Craig Rd
#310
Las Vegas, NV 89130

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1404345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720396800000",
    "number": "1508272188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14050 N 83RD AVE STE 290",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815650",
            "telephone_number": "888-495-4489",
            "fax_number": "602-865-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16427 N SCOTTSDALE RD STE 410",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852547102",
            "telephone_number": "888-495-4489",
            "fax_number": "602-865-8090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16427 N Scottsdale Rd Ste 410",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852547102",
            "country_code": "US",
            "telephone_number": "888-495-4489",
            "fax_number": "602-325-0169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ONESOURCE SENIOR HEALTHCARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-03",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A",
        "authorized_official_last_name": "SHABA",
        "authorized_official_first_name": "PHDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "888-495-4489",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "944102",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OneSource Mobile Healthcare PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.