Individual provider Active NPI

Isabelle Samarah Azar, PA-C

  • Physician Assistant
  • Lake Havasu City, AZ
National Provider Identifier
1053127753
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11401 Issued in AZ
Practice address
309 Lake Havasu Ave S
Lake Havasu City, AZ 86403-9309
Phone
(928) 453-1970
Fax
(855) 538-3082
NPI assigned
Dec 6, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 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 11401 AZ Primary

Addresses

Primary practice location

309 Lake Havasu Ave S
Lake Havasu City, AZ 86403-9309

Mailing address

309 Lake Havasu Ave S
Lake Havasu City, AZ 86403-9309
Phone (928) 453-1970

Other practice location 1

2035 Mesquite Ave
Lake Havasu City, AZ 86403-5894
Phone (928) 208-4598

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
I20251122001294 AZ Practitioner - Physician Assistant 3072005420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prescott Healthcare Solutions LLCGroup PAC ID 4385940295, 199 clinicians

Practice addresses (Care Compare)

309 Lake Havasu Ave S
Lake Havasu City, AZ 86403-9309
Phone (928) 453-1970

Hospital & facility affiliations

  • Havasu Regional Medical Center Hospital, Lake Havasu City, AZ, CCN 030069
  • Kingman Regional Medical Center Hospital, Kingman, AZ, CCN 030055

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11401AZMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Prescott Healthcare Solutions LLC CurrentSince Nov 17, 2025 Accepting new patients

Locations

2500 Canyon Rd
Ste A1
Bullhead City, AZ 86442
Phone (928) 704-4499

309 Lake Havasu Ave S
Lake Havasu City, AZ 86403
Phone (928) 453-1970

2035 Mesquite Ave
Lk Havasu Cty, AZ 86403
Phone (928) 208-4598

3151 N Windsong Dr
Prescott Vly, AZ 86314
Phone (928) 458-7583

Organizations & group practices 1

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 2

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": "1733443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762819200000",
    "number": "1053127753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 LAKE HAVASU AVE S",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864039309",
            "telephone_number": "928-453-1970",
            "fax_number": "855-538-3082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 LAKE HAVASU AVE S",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864039309",
            "telephone_number": "928-453-1970",
            "fax_number": "855-538-3082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2035 Mesquite Ave",
            "address_purpose": "LOCATION",
            "city": "Lake Havasu City",
            "state": "AZ",
            "postal_code": "864035894",
            "country_code": "US",
            "telephone_number": "928-208-4598",
            "fax_number": "888-571-6436",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AZAR",
        "first_name": "ISABELLE",
        "middle_name": "SAMARAH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-06",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "11401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

Verify at the official NPI Registry.