Shelby Leigh Coplen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

6768 Issued in AZ

Practice address

7530 N Oracle Rd Ste 102
Tucson, AZ 85704-4451

Phone

(520) 612-7722

Fax

(520) 612-7797

NPI assigned

Jul 27, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arizona Mohs Surgery PLLCGroup PAC ID 3173944634, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Arizona Mohs Surgery, PLLC

  • MOHS-Micrographic Surgery Physician
  • Tucson, AZ
  • NPI 1588297402
  Medicare reassignment Care Compare group
• Dyson Dermatology PLLC

  • Dermatology Physician
  • Tucson, AZ
  • NPI 1215291414
  Medicare reassignment
• Dyson Dermatology PLLC

  • Dermatology Physician
  • Green Valley, AZ
  • NPI 1396500476
  NPD (past)
• Randall S. Prust MD PC

  • Pain Medicine (Anesthesiology) Physician
  • Tucson, AZ
  • NPI 1114924354
  NPD (past)
• Randall S. Prust MD PC

  • Interventional Pain Medicine Physician
  • Tucson, AZ
  • NPI 1821652686
  NPD (past)

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

{
    "created_epoch": "1501113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729382400000",
    "number": "1780108100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1323 W DESERT CLOUD PL",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857379259",
            "telephone_number": "317-488-7990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7530 N ORACLE RD STE 102",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857044451",
            "telephone_number": "520-612-7722",
            "fax_number": "520-612-7797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPLEN",
        "first_name": "SHELBY",
        "middle_name": "LEIGH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-27",
        "last_updated": "2024-10-20",
        "certification_date": "2024-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14110244",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "322251",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "referrals@azmohs.emadirect.md",
            "affiliation": "N",
            "endpointDescription": "company direct mail address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7530 N Oracle Rd Ste 102",
            "city": "Tucson",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "857044451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Andrea Copeland, M.S
• Maricon Dizon Copeland, DMD
• Ronald Edward Copeland, LCSW
• Amy E. Copfer, PHARMD, BCNSP
• Copihue Counseling, LLC
• Amy Lauren Copler, MS, SLPA
• Copper Regional Pain Services Inc
• Copper State Hospice Inc
• Copper Valley Primary Care
• Copperstate OB-GYN Associates, LTD

• Physician Assistant in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.