Individual provider Active NPI

Steven K Struthers, PA-C

  • Physician Assistant
  • Lakeside, AZ
National Provider Identifier
1114583291
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4830 Highway 260 Ste 103
Lakeside, AZ 85929-5851
Phone
(928) 537-8777
Fax
(928) 537-1914
NPI assigned
May 14, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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 AZ Primary

Addresses

Primary practice location

4830 Highway 260 Ste 103
Lakeside, AZ 85929-5851

Mailing address

4830 Highway 260 Ste 103
Lakeside, AZ 85929-5851
Phone (928) 537-8777

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
I20200221000815 AZ Practitioner - Physician Assistant 0244667707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jeffrey M Reagan MD PLLCGroup PAC ID 5890912653, 2 clinicians

Practice addresses (Care Compare)

4830 Hwy 260
Suite 103
Lakeside, AZ 85929-5851
Phone (928) 537-8777

4830 Hwy 260 103
Lakeside, AZ 85929-5851

Hospital & facility affiliations

  • My Daughters Home Health Agency LLC Home health agency, Show Low, AZ, CCN 037837
  • Summit Healthcare Regional Medical Center Hospital, Show Low, AZ, CCN 030062
  • White Mountain Regional Medical Center Hospital, Springerville, AZ, CCN 031315

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7498AZMDPhysical Medicine & Rehabilitation Physician

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1557792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1114583291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4830 HIGHWAY 260 STE 103",
            "city": "LAKESIDE",
            "state": "AZ",
            "postal_code": "859295851",
            "telephone_number": "928-537-8777",
            "fax_number": "928-537-1914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4830 HIGHWAY 260 STE 103",
            "city": "LAKESIDE",
            "state": "AZ",
            "postal_code": "859295851",
            "telephone_number": "928-537-8777",
            "fax_number": "928-537-1914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRUTHERS",
        "first_name": "STEVEN",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-14",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeside, AZ

Sources for this page

Verify at the official NPI Registry.