Individual provider Active NPI

Svetlana Mahan, PA

  • Surgical Physician Assistant
  • Tucson, AZ
National Provider Identifier
1104278373
Registry record updated Oct 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
3601 S 6TH Ave
Tucson, AZ 85723
Phone
(520) 792-1450
NPI assigned
Jul 12, 2016
Last updated
Oct 3, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

3601 S 6TH Ave
Tucson, AZ 85723

Mailing address

3601 S 6TH Ave
Tucson, AZ 85723-0001
Phone (520) 792-1450

Other practice location 1

12200 Warwick Blvd
Suite 310
Newport News, VA 23601-2344
Phone (757) 534-9988

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1468281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1104278373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 S 6TH AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857230001",
            "telephone_number": "520-792-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 S 6TH AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85723",
            "telephone_number": "520-792-1450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12200 Warwick Blvd",
            "address_2": "Suite 310",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236012344",
            "country_code": "US",
            "telephone_number": "757-534-9988",
            "fax_number": "757-534-5688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHAN",
        "first_name": "SVETLANA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-12",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.