Organization Active NPI

Plastic Surgeons of Northern Arizona,PLLC

  • Plastic Surgery Physician
  • Flagstaff, AZ
National Provider Identifier
1073703732
Registry record updated Jul 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
PLASTIC SURGEONS OF NORTHERN ARIZONA,PLLC
Practice address
1020 N San Francisco St
Suite 200
Flagstaff, AZ 86001-3281
Phone
(928) 774-2300
NPI assigned
Jul 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2007

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

Authorized official

Name
Steven T Schwartz
Title
Administrator
Phone
(928) 214-2111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

1020 N San Francisco St
Suite 200
Flagstaff, AZ 86001-3281

Mailing address

1020 N San Francisco St
Suite 200
Flagstaff, AZ 86001-3281
Phone (928) 774-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040211000614 AZ Part B Supplier - Clinic/Group Practice 8224922182 Receives reassigned benefits from 7 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sedona, AZ; Prescott, AZ; Kingman, AZ; Flagstaff, AZ; Cottonwood, AZ

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Plastic Surgeons of Northern Arizona P L L C2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185753600000",
    "number": "1073703732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 N SAN FRANCISCO ST",
            "address_2": "SUITE 200",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013281",
            "telephone_number": "928-774-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 N SAN FRANCISCO ST",
            "address_2": "SUITE 200",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013281",
            "telephone_number": "928-774-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC SURGEONS OF NORTHERN ARIZONA,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-30",
        "last_updated": "2007-07-30",
        "status": "A",
        "authorized_official_last_name": "SCHWARTZ",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "928-214-2111"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.