Sophia Sheikh, PA-C
Individual provider Active NPI Physician Assistant · Belton, MO
NPI 1689389504 · NPPES record last updated Jul 27, 2024
Key facts
- NPI
- 1689389504
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 2023001505 (MO)
- Practice address
- 105 Bernard Dr
Belton, MO 64012-6181 - Phone
- (248) 660-1220
- NPI assigned
- Jan 16, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240930003164 | MO | Practitioner - Physician Assistant | 5698206779 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2023001505 | MO | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Theoria Medical | Physician Assistant | Current |
Accepting new patients |
| Complexcare Medical Group Midwest H PLLC | Current |
Accepting new patients |
Locations
335 Illinois St
Crystal Lake, IL 60014
Phone (815) 459-7791
41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763
3002 John Duffy Dr
Joplin, MO 64804
Phone (417) 553-9767
9191 N Ambassador Dr
Kansas City, MO 64154
Phone (816) 491-6190
4301 NE Parvin Rd
North Kansas City, MO 64117
Phone (816) 444-0900
2150 W Randolph St
Saint Charles, MO 63301
Phone (636) 946-4966
505 W Evergreen St
Strafford, MO 65757
Phone (417) 736-9332
809 W Benton St
Windsor, MO 65360
Phone (660) 467-3102
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | |||
| Medical Physician Assistant | 363AM0700X | 2023001505 | MO | |
| Physician Assistant | 363A00000X | 2023001505 | MO | Yes |
Addresses
Primary practice location
105 Bernard Dr
Belton, MO 64012-6181
Mailing address
PO Box 772290
Detroit, MI 48277-0001
Other providers in Belton, MO
- Serc Hand of Cass County LLC
- Serc Rehabilitation Partners LLC
- Serc Rehabilitation Partners, LLC
- Serc Rehabilitation Partners, LLC
- Sydney Shatzer
- Karen Elizabeth Shriner
- Austin M Shrout
- Tracey Ann Siemens
- Signature Medical Group of KC, PA
- Skylark Dental LLP
All providers in Belton, MO · Physician Assistant in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 27, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.