Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shane Joseph Ewalt, PHYSICIANASSISTANT

Individual provider Surgical Physician Assistant · NPI 1679091920

Shane Joseph Ewalt, PHYSICIANASSISTANT is a Physician Assistant in Chandler, Arizona. Qualified in 2017, 9 years ago. Practices with Orthopedic Specialists of North America PLLC, a 309-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
9
Licensed in
AZ
In the registry since
2017
Specialties on file
2
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Practice location Address checks out

525 S Chandler Village Dr
Chandler, AZ 85226-5069
Phone: (480) 750-0303
Fax: (480) 786-5202
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 6865 (AZ)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 6865 (AZ)

Record details

NPI number1679091920
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedSeptember 7, 2017
Last updated in NPPESJuly 29, 2022
Certification dateJuly 29, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Orthopedic Specialists Of North America Pllc — 309 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Chandler