Individual provider Active NPI

Sophie Shizuyo Jessop, PA-C

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1912463084
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7422 Issued in AZ
Practice address
2620 N 3Rd St Ste 102
Phoenix, AZ 85004-1153
Phone
(480) 756-6000
NPI assigned
Feb 14, 2019
Last updated
Jul 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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 7422 AZ Primary

Addresses

Primary practice location

2620 N 3Rd St Ste 102
Phoenix, AZ 85004-1153

Mailing address

2620 N 3Rd St Ste 102
Phoenix, AZ 85004-1153
Phone (928) 243-6434

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
I20190530000260 AZ Practitioner - Physician Assistant 8325381668 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Perinatal Services LLCGroup PAC ID 1658505011, 61 clinicians

Practice addresses (Care Compare)

1910 W Frye Rd
Chandler, AZ 85224-6236
Phone (480) 467-2145

2620 N 3Rd St
Suite 103
Phoenix, AZ 85004-1153
Phone (480) 756-6000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7422AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fetal and Women's Center of Arizona, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sophie.jessop.1@20219.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1550102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1912463084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 N 3RD ST STE 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041153",
            "telephone_number": "928-243-6434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 N 3RD ST STE 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041153",
            "telephone_number": "480-756-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESSOP",
        "first_name": "SOPHIE",
        "middle_name": "SHIZUYO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-14",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "7422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.