Individual provider Active NPI

Andrew White, PA-C

  • Physician Assistant
  • Safford, AZ
National Provider Identifier
1043791247
Registry record updated Aug 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1600 S 20TH Ave
Safford, AZ 85546-4011
Phone
(928) 348-4000
NPI assigned
Aug 24, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2018

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 AZ Primary

Addresses

Primary practice location

1600 S 20TH Ave
Safford, AZ 85546-4011

Mailing address

10402 E Javelina Ave
Mesa, AZ 85209-7747
Phone (480) 203-4399

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
I20190214002023 AZ Practitioner - Physician Assistant 0941548093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Clinica la Familia PCGroup PAC ID 4082694781, 38 clinicians

Practice addresses (Care Compare)

1315 W Southern Ave
Tempe, AZ 85282-4519
Phone (602) 569-3999

616 E Southern Ave
Suite 103
Mesa, AZ 85204-4941
Phone (602) 569-3999

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Kidney Associates PLC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1535068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535068800000",
    "number": "1043791247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10402 E JAVELINA AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852097747",
            "telephone_number": "480-203-4399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S 20TH AVE",
            "city": "SAFFORD",
            "state": "AZ",
            "postal_code": "855464011",
            "telephone_number": "928-348-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "ANDREW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-24",
        "last_updated": "2018-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Safford, AZ

Sources for this page

Verify at the official NPI Registry.