Individual provider Active NPI

Nour Shiblak

  • Physician Assistant
  • Paradise Valley, AZ
National Provider Identifier
1770420622
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
5519 E Beryl Ave
Paradise Valley, AZ 85253-1165
Phone
(480) 707-1361
NPI assigned
Apr 29, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X AZ Primary

Addresses

Primary practice location

5519 E Beryl Ave
Paradise Valley, AZ 85253-1165

Mailing address

5519 E Beryl Ave
Paradise Valley, AZ 85253-1165
Phone (480) 707-1361

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1 Zotec Way
Carmel, IN 46032-0052

PO Box
Suite 2916
Phoenix, AZ 85062

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1777420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1770420622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5519 E BERYL AVE",
            "city": "PARADISE VALLEY",
            "state": "AZ",
            "postal_code": "852531165",
            "telephone_number": "480-707-1361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5519 E BERYL AVE",
            "city": "PARADISE VALLEY",
            "state": "AZ",
            "postal_code": "852531165",
            "telephone_number": "480-707-1361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIBLAK",
        "first_name": "NOUR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-04-29",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paradise Valley, AZ

Sources for this page

Verify at the official NPI Registry.