NPIMap

Individual provider Active NPI

Michael Millette, PA-C

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1043259591
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2866 Issued in AZ
Practice address
13838 S 46TH PL
Suite 115
Phoenix, AZ 85044-7800
Phone
(480) 496-0000
Fax
(480) 496-7235
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 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 2866 AZ Primary

Addresses

Primary practice location

13838 S 46TH PL
Suite 115
Phoenix, AZ 85044-7800

Mailing address

801 W Azure LN
Litchfield Park, AZ 85340-5087
Phone (623) 882-1331

Other identifiers 1

IdentifierTypeStateIssuer
813635MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Shea Urgent Care LLC Past Accepting new patients
Will Jeffers D.O., P.C. Past Accepting new patients
Med 97 LLC Past Accepting new patients
Apache Junction Urgent Care LLC Past Accepting new patients
Pinnacle Medicine Inc. Past Accepting new patients
Southwest Phoenix Urgent Care LLC Past Accepting new patients
Sun City Urgent Care LLC Past Accepting new patients
Dana Landing Urgent Care LLC Past Accepting new patients
Desert Ridge Urgent Care LLC Past Accepting new patients
Walloon Lake Recovery Lodge, LLC PastSince Nov 10, 2019 Accepting new patients
Team Physicians of Arizona PC Physician Assistant Past Accepting new patients
Foothills Primary Care LLC Past Accepting new patients
Thomas Road Urgent Care LLC Past Accepting new patients
Avondale Urgent Care LLC Past Accepting new patients
Greenway Urgent Care LLC Past Accepting new patients
Glendale Urgent Care LLC Past Accepting new patients
Chandler Urgent Care LLC Past Accepting new patients
Center for Physical Medicine & Rehabilitation P C Past Accepting new patients
Casa Grande Urgent Care LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: michael.millette.1@21307.direct.athenahealth.com

Organizations & group practices 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1043259591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 W AZURE LN",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853405087",
            "telephone_number": "623-882-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13838 S 46TH PL",
            "address_2": "SUITE 115",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850447800",
            "telephone_number": "480-496-0000",
            "fax_number": "480-496-7235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLETTE",
        "first_name": "MICHAEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "2866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "813635",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.