Individual provider Active NPI

Paul Pearson Panasiuk, MD

  • Obstetrics & Gynecology Physician
  • Flagstaff, AZ
National Provider Identifier
1063906493
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
67378 Issued in AZ
Practice address
2920 N 4TH St
Flagstaff, AZ 86004-1816
Phone
(928) 522-9400
NPI assigned
Jun 19, 2018
Last updated
Aug 29, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 67378 AZ Primary

Addresses

Primary practice location

2920 N 4TH St
Flagstaff, AZ 86004-1816

Mailing address

PO Box 3630
Flagstaff, AZ 86003-3630

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, CO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220909002890 AZ Practitioner - Obstetrics/Gynecology 4587913157
I20260116003799 CO Practitioner - Obstetrics/Gynecology 4587913157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Wisconsin School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3 Superior Dr
Suite 400
Superior, CO 80027-8656
Phone (303) 673-1440

300 Exempla Cir
Lafayette, CO 80026-3396

8350 Colorado Blvd
Unit 160
Firestone, CO 80504-6803
Phone (303) 673-1370

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
67378AZMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Country Healthcare, Inc. CurrentSince Sep 1, 2022 Accepting new patients
North Country Healthcare, Inc. Current Accepting new patients
North Country Healthcare, Inc. CurrentSince Sep 1, 2022 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Feb 16, 2026 Accepting new patients
North Country Healthcare, Inc. Family Medicine Current Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Feb 16, 2026 Accepting new patients
Intermountain Medical Group Denver, LLC Family Medicine Past Accepting new patients
North Country Healthcare, Inc. Past Accepting new patients
Flagstaff Medical Center Past Accepting new patients

Locations

1120 W University Ave
Ste 101
Flagstaff, AZ 86001
Phone (928) 522-1300

2920 N 4th St
Flagstaff, AZ 86004
Phone (928) 213-6100

620 Lee St
Winslow, AZ 86047
Phone (928) 288-8700

3 Superior Dr
Ste 400
Superior, CO 80027
Phone (303) 673-1440

Organizations & group practices 9

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": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1063906493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3630",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860033630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 N 4TH ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860041816",
            "telephone_number": "928-522-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANASIUK",
        "first_name": "PAUL",
        "middle_name": "PEARSON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-19",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "67378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.