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ANGEL SHIBU PA-C
NPI 1073494191
Physician Assistant in Desoto, TX

Active since September 08, 2025PECOS Enrolled
2701 PRINCE GEORGE AVE STE 100, DESOTO, TX 75115(972) 634-8110 Get Directions Write a Review

NPPES record last updated: October 6, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 6, 2025, Sep 8, 2025 (2 updates tracked since 2025).

About Angel Shibu Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANGEL SHIBU PA-C (NPI 1073494191) is an individual physician assistant in Desoto, Texas, licensed in Texas (PA19530) and active in the NPI registry since September 2025. She is enrolled in Medicare PECOS and is a graduate of University Of Texas Medical Branch At Galveston (2025).

NPPES Registry Identity

NPI1073494191
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameANGEL SHIBUCredential: PA-C
Location Address2701 PRINCE GEORGE AVE STE 100Desoto, TX 75115-2087
Mailing Address2701 Prince George Ave Ste 100Desoto, TX 75115-2087 · (972) 634-8110
Phone(972) 634-8110
Sole ProprietorNo
Medical School CMSUniversity Of Texas Medical Branch At GalvestonGraduated 2025
Enumeration DateSeptember 8, 2025
Last NPPES UpdateOctober 6, 20252 updates tracked since enumeration
NPPES CertifiedOctober 6, 2025
✔ NPI 1073494191 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in TX · PA19530
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
2701 PRINCE GEORGE AVE STE 100, Desoto, TX 75115
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Angel Shibu Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7214428416
PECOS Enrollment IDI20251117000140
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75115 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.19 typical visit price
range $57.18 – $172.86
Typical copayment $22.04 (range $14.29 – $43.21)
Most-billed visit code 99203
Established Patient
$71.28 typical visit price
range $18.48 – $141.20
Typical copayment $17.82 (range $4.62 – $35.30)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NOEMI RODRIGUEZ FNP-C
Nurse Practitioner (Family)
2701 PRINCE GEORGE AVE STE 100
DESOTO, TX 75115
Dallas County (972) 634-8110
THE DALLAS CLINIC 23 PLLC
Internal Medicine
2701 PRINCE GEORGE AVE STE 100
DESOTO, TX 75115
Dallas County (972) 634-8110
SHEHETAJ G ABDURRAHIM MD
Internal Medicine
2701 PRINCE GEORGE AVE STE 100
DESOTO, TX 75115
Dallas County (972) 634-8110
DONALD G NICHOLAS JR MD
General Practice
2701 PRINCE GEORGE AVE STE 100
DESOTO, TX 75115
Dallas County (972) 224-9090

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Angel Shibu's NPI number?

The NPI number for Angel Shibu is 1073494191. It was assigned to this individual provider in the NPPES registry on September 8, 2025.

Where is Angel Shibu located?

Angel Shibu practices at 2701 Prince George Ave Ste 100, Desoto, TX 75115. The listed phone number is (972) 634-8110.

What is Angel Shibu's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Angel Shibu enrolled in Medicare?

Yes. Angel Shibu is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Angel Shibu was last updated on October 6, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.