Active NPI
Anita Shiwach
- Physician Assistant
- Desoto, TX
National Provider Identifier
1508335050
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA12350
- Practice address
- 941 York Dr Ste 205
Desoto, TX 75115-2066 - Phone
- (972) 283-6286
- NPI assigned
- Nov 14, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA12350 | TX | Primary |
Addresses
Primary practice location
941 York Dr Ste 205
Desoto, TX 75115-2066
Mailing address
941 York Dr Ste 205
Desoto, TX 75115-2066
Phone (972) 283-6286
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
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)
941 York Dr
Suite 200
Desoto, TX 75115-2066
Phone (972) 283-6286
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA12350 | TX | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Albert Boyd MD PA | 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 and National Provider Directory roles.
-
- Psychiatry Physician
- Desoto, TX
- NPI 1750589016
-
- Family Medicine Physician
- Desoto, TX
- NPI 1336329150
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711584000000",
"number": "1508335050",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "941 YORK DR STE 205",
"city": "DESOTO",
"state": "TX",
"postal_code": "751152066",
"telephone_number": "972-283-6286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "941 YORK DR STE 205",
"city": "DESOTO",
"state": "TX",
"postal_code": "751152066",
"telephone_number": "972-283-6286"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIWACH",
"first_name": "ANITA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-11-14",
"last_updated": "2024-03-28",
"certification_date": "2024-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA12350",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Desoto, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.