Paul Anthony Shakstad Jr., PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-2570 Issued in ID

Practice address

5700 E Highway 90
Sierra Vista, AZ 85635-9110

Phone

(520) 263-2000

NPI assigned

Oct 30, 2017

Last updated

Aug 21, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ, ID2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pshakstad2908129@direct.trinity-health.org

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.

• Northwest HBP Medical Services LLC

  • Emergency Medicine Physician
  • Tucson, AZ
  • NPI 1407353006
  Medicare reassignment
• Progressive Medical Associates PLLC

  • Emergency Medicine Physician
  • Mesa, AZ
  • NPI 1548218613
  Medicare reassignment
• Scottsdale Emergency Associates, LTD.

  • Emergency Medicine Physician
  • Scottsdale, AZ
  • NPI 1083671432
  Medicare reassignment
• Sound Physicians Emergency Medicine of Arizona, Inc.

  • Emergency Medicine Physician
  • Sierra Vista, AZ
  • NPI 1700328663
  Medicare reassignment
• Cep America, LLC

  dba Vituity

  • Emergency Medicine Physician
  • Boise, ID
  • NPI 1811357023
  Medicare reassignment
• Scottsdale Emergency Associates, LTD.

  • Emergency Medicine Physician
  • Scottsdale, AZ
  • NPI 1023298551

  Physician Assistant

  NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946
  NPD
• Cep America, LLC

  dba Vituity

  • Emergency Medicine Physician
  • Eagle, ID
  • NPI 1700246915
  NPD

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

{
    "created_epoch": "1509321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1568974632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 S LENZNER AVE APT 7205",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856355643",
            "telephone_number": "310-529-1614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 E HIGHWAY 90",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856359110",
            "telephone_number": "520-263-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAKSTAD",
        "first_name": "PAUL",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-30",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6821",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-2570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Sellars, N.P.
• Set Sail 2.0 Inc. (Southern Arizona Seniors Helping Seniors)
• Anita Sette
• Artur Setyan, D.O.
• Nettie Seward, RN
• Jessica Shamas, FNP-C
• Meredith Shamas, FNP-C
• Quinton Shapcott, DPT
• Charles Shaw, DO
• Pamela Ann Sheean, OTR

• Physician Assistant in Sierra Vista, AZ
• Providers in Sierra Vista, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.