Individual provider Active NPI

Korie Brooke McQuaite, PA-C

  • Physician Assistant
  • Mesa, AZ
National Provider Identifier
1033667381
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA059832 Issued in PA
Practice address
2152 S Vineyard Ste 138
Mesa, AZ 85210-6882
Phone
(480) 539-6646
Fax
(480) 539-6696
NPI assigned
Sep 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 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 MA059832 PA Primary

Addresses

Primary practice location

2152 S Vineyard Ste 138
Mesa, AZ 85210-6882

Mailing address

2152 S Vineyard Ste 138
Mesa, AZ 85210-6882
Phone (480) 539-6646

Other practice location 1

6200 N La Cholla Blvd
Tucson, AZ 85741-3529
Phone (520) 469-8032

Other names 1

  • Korie Brooke Brust Former name

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
I20161028000528 AZ Practitioner - Physician Assistant 1557649498 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA059832PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Honorhealth CurrentSince Jul 25, 2023 Accepting new patients
Scottsdale Emergency Associates, LTD. Physician Assistant CurrentSince Jan 1, 2023 Accepting new patients
Honorhealth CurrentSince Jul 25, 2023 Accepting new patients
Northwest Tucson Emergency Physicians Physician Assistant Past Accepting new patients
Arizona OB GYN Affiliates PC Past Accepting new patients
Valley Perinatal Services, LLC PastSince Feb 23, 2020 Accepting new patients

Locations

5316 E Shea Blvd
Ste 150
Scottsdale, AZ 85254
Phone (480) 534-4530

7400 E Osborn Rd
Scottsdale, AZ 85251
Phone (480) 481-4000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20219/brand/1/csg/1/fhir/r4

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1473897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1033667381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2152 S VINEYARD STE 138",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852106882",
            "telephone_number": "480-539-6646",
            "fax_number": "480-539-6696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2152 S VINEYARD STE 138",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852106882",
            "telephone_number": "480-539-6646",
            "fax_number": "480-539-6696"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6200 N La Cholla Blvd",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857413529",
            "country_code": "US",
            "telephone_number": "520-469-8032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCQUAITE",
        "first_name": "KORIE",
        "middle_name": "BROOKE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-15",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA059832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KORIE",
            "last_name": "BRUST",
            "middle_name": "BROOKE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.