Susan Elizabeth Bray, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

2488 Issued in AZ

Practice address

2040 W Bethany Home Rd Ste 123
Phoenix, AZ 85015-2445

Phone

(480) 840-1754

Fax

(480) 840-1764

NPI assigned

Jan 12, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Privia Medical Group Arizona, LLC

  • Family Medicine Physician
  • Payson, AZ
  • NPI 1740459700
  NPD (past)
• Privia Medical Group Arizona, LLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1760441141
  NPD (past)

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555459200000",
    "number": "1053461673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 E BELL RD STE 2200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322139",
            "telephone_number": "602-633-3838",
            "fax_number": "602-633-3845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 W BETHANY HOME RD STE 123",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850152445",
            "telephone_number": "480-840-1754",
            "fax_number": "480-840-1764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAY",
        "first_name": "SUSAN",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2019-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "2488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "834312",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brave Star Health Inc
• Dulce Bravo Flores
• Brenda Bravo
• Victoria Bravo, OWNER
• Laverne Braxton, MS
• Gregory Braylock, RPH
• Perry A. Brazel, PA-C
• Randy Brazie, M.D.
• Sarah Brazil, RBT
• Daniela Brazovan, COTA/L

• Medical Physician Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2019; 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.