Individual provider Active NPI

Taylor Ann Buckminster, PA-C

  • Physician Assistant
  • Peoria, AZ
National Provider Identifier
1083337828
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
13460 N 94TH Dr Ste J1
Peoria, AZ 85381-4264
Phone
(623) 876-8816
Fax
(623) 298-0168
NPI assigned
Sep 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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 Primary

Addresses

Primary practice location

13460 N 94TH Dr Ste J1
Peoria, AZ 85381-4264

Mailing address

13460 N 94TH Dr Ste J1
Peoria, AZ 85381-4264
Phone (623) 876-8816

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
I20240313003976 AZ Practitioner - Physician Assistant 4789052697 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
86.61 of 100Reported as group
Quality
87.74
Promoting interoperability
100
Improvement activities
40
Cost
67.62

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9942AZMDPhysical Therapist

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.

NPI Registry JSON

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

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1083337828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13460 N 94TH DR STE J1",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814264",
            "telephone_number": "623-876-8816",
            "fax_number": "623-298-0168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13460 N 94TH DR STE J1",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814264",
            "telephone_number": "623-876-8816",
            "fax_number": "623-298-0168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKMINSTER",
        "first_name": "TAYLOR",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-26",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.