Individual provider Active NPI

Shannon L Stubbs

  • Physician Assistant
  • Scottsdale, AZ
National Provider Identifier
1538059951
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11362 Issued in AZ
Practice address
17300 N Perimeter Dr Ste 220
Scottsdale, AZ 85255-6703
Phone
(480) 661-2661
NPI assigned
Jul 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 11362 AZ Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

17300 N Perimeter Dr Ste 220
Scottsdale, AZ 85255-6703

Mailing address

10200 Grand Central Ave Ste 220
Owings Mills, MD 21117-4366
Phone (480) 661-2661

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251023002031 AZ Practitioner - Physician Assistant 6709374424 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arizona Urology Specialists PLLCGroup PAC ID 5092863852, 84 clinicians

Practice addresses (Care Compare)

17300 N Perimeter Dr
Suite 220
Scottsdale, AZ 85255-6703
Phone (480) 661-2662

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11362AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Urology Specialists, PLLC CurrentSince Oct 7, 2025 Accepting new patients

Locations

2530 E Southern Ave
Mesa, AZ 85204
Phone (480) 834-4188

17300 N Perimeter Dr
Ste 220
Scottsdale, AZ 85255
Phone (480) 661-2661

10200 Grand Central Ave
Ste 220
Owings Mills, MD 21117

Interoperability endpoints

  • Direct secure messaging: shannonstubbs@tsicua.allscriptsdirect.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1751846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1538059951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 GRAND CENTRAL AVE STE 220",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211174366",
            "telephone_number": "480-661-2661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17300 N PERIMETER DR STE 220",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852556703",
            "telephone_number": "480-661-2661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUBBS",
        "first_name": "SHANNON",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-07",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "11362",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.