Roxanne Rea, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5184 Issued in AZ

Practice address

6410 S Kings Ranch Rd
Gold Canyon, AZ 85118-7352

Phone

(480) 981-3000

Fax

(480) 654-5761

NPI assigned

Oct 2, 2012

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

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

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Deseret Medical Associates PLCGroup PAC ID 5698026409, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Home Care-Arizona Home health agency, Mesa, AZ, CCN 037015
• Banner Baywood Medical Center Hospital, Mesa, AZ, CCN 030088

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ACABDD/Endpoint/ACABDD

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.

• Deseret Medical Associates PLC

  • Family Medicine Physician
  • Gold Canyon, AZ
  • NPI 1962989244
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Banner Baywood Medical Center

  • General Acute Care Hospital
  • Mesa, AZ
  • NPI 1194758284
  Care Compare affiliation
• Banner Home Care-Arizona

  • Home Health Agency
  • Sun City, AZ
  • NPI 1023051927
  Care Compare affiliation

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

{
    "created_epoch": "1349136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1104177096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6410 S KINGS RANCH RD",
            "city": "GOLD CANYON",
            "state": "AZ",
            "postal_code": "851187352",
            "telephone_number": "480-981-3000",
            "fax_number": "480-654-5761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 S KINGS RANCH RD",
            "city": "GOLD CANYON",
            "state": "AZ",
            "postal_code": "851187352",
            "telephone_number": "480-981-3000",
            "fax_number": "480-654-5761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REA",
        "first_name": "ROXANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-02",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "5184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Physical Therapy Clinic of Gold Canyon
• Jacqueline M Potokar, CERTIFIED CARE GIVER
• Jordan Christopher Pozniak, P.T, DPT
• Raley'S Arizona LLC
• RCS Home Care LLC
• Restore DME Medical Group, LLC
• Janet F Rinehart, FNP-BC
• Robert D. Lancaster, MD, PC
• Jonathan David Rodis, LPC
• Patricia Ann Rossboro, RPH

• Medical Physician Assistant in Gold Canyon, AZ
• Providers in Gold Canyon, 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 Mar 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.