Individual provider Active NPI

Amy Leticia Brown, PA-C

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1003527011
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9802 Issued in AZ
Practice address
5777 E Mayo Blvd
Phoenix, AZ 85054-4502
Phone
(480) 301-8000
NPI assigned
Dec 9, 2022
Last updated
Oct 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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 9802 AZ Primary

Addresses

Primary practice location

5777 E Mayo Blvd
Phoenix, AZ 85054-4502

Mailing address

5777 E Mayo Blvd
Phoenix, AZ 85054-4502
Phone (480) 301-8000

Other practice location 1

435 N 5th St
Phoenix, AZ 85004-2157
Phone (559) 817-7802

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, AR2 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

Enrollment IDStateProvider typePAC IDDetails
I20231030003400 AZ Practitioner - Physician Assistant 2365898103 Reassigns benefits to 1 organization
I20250130004116 AR Practitioner - Physician Assistant 2365898103 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

813 Founders Park Dr E
Suite 101
Springdale, AR 72762-6321
Phone (479) 463-2333

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.47 of 100Reported as group
Quality
78.27
Promoting interoperability
100
Improvement activities
40
Cost
76.62

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Regional Medical System CurrentSince Feb 1, 2025 Accepting new patients
Washington Regional Medical System CurrentSince Feb 1, 2025 Accepting new patients
Mayo Clinic Arizona CurrentSince Oct 4, 2023 Accepting new patients
Mayo Clinic Arizona CurrentSince Oct 4, 2023 Accepting new patients
Washington Regional Medical System CurrentSince Feb 1, 2025 Accepting new patients
Washington Regional Medical System Past Accepting new patients

Locations

114 E Sunbridge Dr
Fayetteville, AR 72703
Phone (479) 463-2597

813 Founders Park Dr W
Ste 201
Springdale, AR 72762
Phone (479) 463-5500

5777 E Mayo Blvd
Phoenix, AZ 85054
Phone (480) 342-1800

13400 E Shea Blvd
Scottsdale, AZ 85259

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

Interoperability endpoints

  • Direct secure messaging: abrown47957@washingtonregional.direct-ci.com

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1670544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1003527011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5777 E MAYO BLVD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850544502",
            "telephone_number": "480-301-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5777 E MAYO BLVD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850544502",
            "telephone_number": "480-301-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "435 N 5th St",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850042157",
            "country_code": "US",
            "telephone_number": "559-817-7802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "AMY",
        "middle_name": "LETICIA",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-09",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "9802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.