Individual provider Active NPI

Natalie Gail Booty, PA-C

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1033691670
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7156 Issued in AZ
Practice address
2000 W Bethany Home Rd
Phoenix, AZ 85015-2443
Phone
(602) 249-0212
NPI assigned
Aug 30, 2018
Last updated
Jan 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 55908 CA
Physician Assistant 363A00000X 7156 AZ Primary
Surgical Physician Assistant 363AS0400X PA22908 CA

Addresses

Primary practice location

2000 W Bethany Home Rd
Phoenix, AZ 85015-2443

Mailing address

2000 W Bethany Home Rd
Phoenix, AZ 85015-2443

Other practice location 1

10037 Schuler Ranch Rd
Elk Grove, CA 95757-5508
Phone (360) 951-7088

Other practice location 2

10037 Schuler Ranch Rd
Elk Grove, CA 95757-5508
Phone (360) 951-7088

Other names 1

  • Natalie Gail Burres Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, AZ2 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
I20190407000022 CA Practitioner - Physician Assistant 3274874987 Reassigns benefits to 1 organization
I20201009001192 AZ Practitioner - Physician Assistant 3274874987 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7156AZMDChiropractor
55908CAMDPharmacist
PA22908CAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America-California CurrentSince Nov 1, 2018 Accepting new patients
Cep America - California CurrentSince Nov 1, 2018 Accepting new patients
Cep America- Arizona, PC CurrentSince Apr 11, 2024 Accepting new patients

Locations

1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

1441 Florida Ave
Modesto, CA 95350
Phone (209) 214-7235

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1033691670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 W BETHANY HOME RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850152443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 W BETHANY HOME RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850152443",
            "telephone_number": "602-249-0212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10037 Schuler Ranch Rd",
            "address_purpose": "LOCATION",
            "city": "Elk Grove",
            "state": "CA",
            "postal_code": "957575508",
            "country_code": "US",
            "telephone_number": "360-951-7088",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10037 Schuler Ranch Rd",
            "address_purpose": "LOCATION",
            "city": "Elk Grove",
            "state": "CA",
            "postal_code": "957575508",
            "country_code": "US",
            "telephone_number": "360-951-7088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOOTY",
        "first_name": "NATALIE",
        "middle_name": "GAIL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-30",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "55908",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "7156",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA22908",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NATALIE",
            "last_name": "BURRES",
            "middle_name": "GAIL",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.