Individual provider Active NPI

Seth D Hanson, PA-C

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1013695295
Registry record updated Jan 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9779 Issued in AZ
Practice address
101 N 1St Ave Ste 2325
Phoenix, AZ 85003-1933
Phone
(602) 518-5866
Fax
(480) 718-8857
NPI assigned
Jul 7, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 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 9779 AZ Primary

Addresses

Primary practice location

101 N 1St Ave Ste 2325
Phoenix, AZ 85003-1933

Mailing address

4111 N 21St St Apt 120
Phoenix, AZ 85016-6164

Other practice location 1

14820 N Cave Creek Rd Ste 2
Phoenix, AZ 85032-4951
Phone (833) 242-0100

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
I20230808000644 AZ Practitioner - Physician Assistant 4486015476 Practice locations: Phoenix, AZ

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

101 N 1St Ave
Suite 2325
Phoenix, AZ 85003-1933
Phone (602) 577-1256

Hospital & facility affiliations

  • Bayada Home Health Care, Inc. Home health agency, Glendale, AZ, CCN 037185

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Az Mobile Health LLC Physician Assistant CurrentSince Dec 1, 2024 Accepting new patients
Cardiovascular Associates of Mesa P C CurrentSince Jul 24, 2023 Accepting new patients

Locations

6116 E Arbor Ave
Ste 112
Mesa, AZ 85206

6309 E Baywood Ave
Ste 101
Mesa, AZ 85206
Phone 48064154004010

101 N 1st Ave
Ste 2325
Phoenix, AZ 85003
Phone (602) 518-5866

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 and National Provider Directory roles.

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": "1688688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737849600000",
    "number": "1013695295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 N 21ST ST APT 120",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850166164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N 1ST AVE STE 2325",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850031933",
            "telephone_number": "602-518-5866",
            "fax_number": "480-718-8857"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14820 N Cave Creek Rd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850324951",
            "country_code": "US",
            "telephone_number": "833-242-0100",
            "fax_number": "623-246-7491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANSON",
        "first_name": "SETH",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-07",
        "last_updated": "2025-01-26",
        "certification_date": "2025-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "9779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.