John M. Altic, PA-C

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

2502 Issued in AZ

Practice address

888 S Greenfield Rd #101
Gilbert, AZ 85296-4012

Phone

(480) 892-1300

Fax

(480) 507-7477

NPI assigned

Jun 28, 2006

Last updated

Jan 11, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Maricopa Physicians PLLCGroup PAC ID 7315271079, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Phoenix Mountain Post Acute Nursing home, Phoenix, AZ, CCN 035072

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Maricopa Physicians PLLC

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1124599816
  Medicare reassignment Care Compare group NPD
• Clark Medical and Post-Acute Services, LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Phoenix, AZ
  • NPI 1437851417
  Medicare reassignment
• Scottsdale Physicians Group PLC

  • Internal Medicine Physician
  • Scottsdale, AZ
  • NPI 1689799579
  Medicare reassignment
• Lookout Mountain Healthcare LLC

  dba Phoenix Mountain Post Acute

  • Skilled Nursing Facility
  • Phoenix, AZ
  • NPI 1427516582
  NPD (past)
• Team Physicians of Arizona PC

  • Emergency Medicine Physician
  • Mesa, AZ
  • NPI 1710915764
  NPD (past)

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

• Lookout Mountain Healthcare LLC

  dba Phoenix Mountain Post Acute

  • Skilled Nursing Facility
  • Phoenix, AZ
  • NPI 1427516582

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294704000000",
    "number": "1124055637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 S GREENFIELD RD #101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852964012",
            "telephone_number": "480-892-1300",
            "fax_number": "480-504-7477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 S GREENFIELD RD #101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852964012",
            "telephone_number": "480-892-1300",
            "fax_number": "480-507-7477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTIC",
        "first_name": "JOHN",
        "middle_name": "M.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2011-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "2502",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "2502",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "726713",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alpha in Home Care (Home Instead Senior Care)
• Alpha Medical Group LLC
• Waleed A. Alsadi, O.D.
• Joanna Alshalabi
• Christine Altamirano, DPT
• Frank Altier Jr., D.M.D.
• Burak Altintas, MD
• Sylvia Wahu Aluoch, NURSE
• Jada Jovaun Alvarado, RBT
• Alba Lucia Alvarez-Stewart, M.S.W., L.C.S.W.

• Emergency Medicine Physician in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Emergency Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; 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.