Individual provider Active NPI

Darren E Shobe, P.A.-C.

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1629399753
Registry record updated Jan 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA06817 Issued in TX
Practice address
1818 E Sky Harbor Cir N Ste 150
Phoenix, AZ 85034-3410
Phone
(602) 244-9500
Fax
(602) 244-9543
NPI assigned
Jun 11, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X
Physician Assistant 363A00000X PA06817 TX Primary
Physician Assistant 363A00000X 5379 AZ

Addresses

Primary practice location

1818 E Sky Harbor Cir N Ste 150
Phoenix, AZ 85034-3410

Mailing address

953 E Buckingham Ave
Gilbert, AZ 85297-1798
Phone (480) 789-2417

Other identifiers 4

IdentifierTypeStateIssuer
281185303MedicaidTX
281185301MedicaidTX
281185302MedicaidTX
29851050MedicaidNM

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
I20130619000596 AZ Practitioner - Physician Assistant 9830387356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1110 E Route 66
Suite 100
Flagstaff, AZ 86001-4772
Phone (928) 773-9695

1710 W Southern Ave
Mesa, AZ 85202-4800
Phone (480) 644-7900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5379AZMDPhysician Assistant
PA06817TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Acute Surgical Care Specialists PLLC Past Accepting new patients
Acute Orthopedic Care Specialists PLLC Past Accepting new patients
Total Orthopedics,LLC Past Accepting new patients

Organizations & group practices 4

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": "1276214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389312000000",
    "number": "1629399753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "953 E BUCKINGHAM AVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852971798",
            "telephone_number": "480-789-2417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 E SKY HARBOR CIR N STE 150",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850343410",
            "telephone_number": "602-244-9500",
            "fax_number": "602-244-9543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOBE",
        "first_name": "DARREN",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-11",
        "last_updated": "2014-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA06817",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "5379",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "281185303",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "281185301",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "281185302",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "29851050",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.