Individual provider Active NPI

Steven Vance Harrison III, PA-C

  • Surgical Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1073918215
Registry record updated Oct 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
6077 Issued in AZ
Practice address
370 E Virginia Ave Ste 100
Phoenix, AZ 85004-1254
Phone
(602) 258-4788
NPI assigned
Oct 30, 2014
Last updated
Oct 7, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 52074 CA
Surgical Physician Assistant 363AS0400X 6077 AZ Primary

Addresses

Primary practice location

370 E Virginia Ave Ste 100
Phoenix, AZ 85004-1254

Mailing address

PO Box 7587
Phoenix, AZ 85011-7587
Phone (602) 258-4788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20151013002292 AZ Practitioner - Physician Assistant 9537482013 Reassigns benefits to 1 organization
I20220527001052 TX Practitioner - Physician Assistant 9537482013 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1520 S Dobson Rd
Suite 210
Mesa, AZ 85202-4753
Phone (602) 258-4788

15830 N 35TH Ave
Suite 1
Phoenix, AZ 85053-7640
Phone (602) 258-4788

3329 E Bell Rd
Suite A5
Phoenix, AZ 85032-2757
Phone (602) 258-4788

370 E Virginia Ave
Suite 100
Phoenix, AZ 85004-1254
Phone (602) 258-4788

9220 E Mountain View Rd
Suite 200
Scottsdale, AZ 85258-5136
Phone (602) 258-4788

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6077AZMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
San Carlos Apache Healthcare Corporation CurrentSince Jan 29, 2022 Accepting new patients
San Carlos Apache Healthcare Corporation CurrentSince Jan 29, 2022 Accepting new patients
Arizona Center for Hand Surgery PC CurrentSince Oct 1, 2015 Accepting new patients
Arizona Center for Hand Surgery PC CurrentSince Oct 1, 2015 Accepting new patients
Arizona Center for Hand Surgery PC Past Accepting new patients

Locations

1955 W Frye Rd
Chandler, AZ 85224
Phone (480) 507-2961

1520 S Dobson Rd
Ste 210
Mesa, AZ 85202
Phone (480) 898-8593

2111 W University Dr
Mesa, AZ 85201
Phone (480) 206-6240

103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200

15830 N 35th Ave
Ste 1
Phoenix, AZ 85053
Phone (602) 298-1188

3329 E Bell Rd
Ste A5
Phoenix, AZ 85032

370 E Virginia Ave
Phoenix, AZ 85004
Phone (480) 206-6240

370 E Virginia Ave
Ste 100
Phoenix, AZ 85004
Phone (602) 200-8988

9220 E Mountain View Rd
Ste 200
Scottsdale, AZ 85258
Phone (480) 451-6756

Organizations & group practices 5

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": "1414627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444176000000",
    "number": "1073918215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7587",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850117587",
            "telephone_number": "602-258-4788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 E VIRGINIA AVE STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041254",
            "telephone_number": "602-258-4788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "STEVEN",
        "middle_name": "VANCE",
        "name_suffix": "III",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-30",
        "last_updated": "2015-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "52074",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "6077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.