Sofia Shalomov, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5573 Issued in AZ

Practice address

9494 W Northern Ave
Glendale, AZ 85305-1118

Phone

(623) 872-2226

NPI assigned

Oct 18, 2013

Last updated

Jul 3, 2017By the provider in NPPES

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 names 1

• Sofia Kandova Former name

Medicare fee-for-service enrollment

Enrolled in AZ, FL2 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

State licenses

Practice roles

Locations

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.

• Nextcare Arizona LLC

  dba NextCare Urgent Care

  • Urgent Care Clinic/Center
  • Tempe, AZ
  • NPI 1043371826
  Medicare reassignment
• Nextcare Arizona I JV LLC

  • Urgent Care Clinic/Center
  • Tempe, AZ
  • NPI 1114798071
  NPD

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

{
    "created_epoch": "1382054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499040000000",
    "number": "1831527373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 N THUNDERBIRD CIR STE 303",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852151219",
            "telephone_number": "623-872-2226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9494 W NORTHERN AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853051118",
            "telephone_number": "623-872-2226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHALOMOV",
        "first_name": "SOFIA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-18",
        "last_updated": "2017-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "5573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SOFIA",
            "last_name": "KANDOVA",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shalash Medical Transportation LLC
• Husam Shalash
• Shalom Behavioral Health, LLC
• Shalom Enrichment Center LLC
• Shalom Heritage LLC- Peace Home
• Shamlock Nursing Services LLC (Shamlock Behavioral Health)
• Shamy Dental Inc (A Gentle Smile Dental Center)
• Shannon M. Coen D.M.D, PC
• Kaitlyn Marie Shannon, RD, LDN
• Shapc LLC (Canyon Home Care & Hospice)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2017; 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.