Individual provider Active NPI

Dory Elizabeth Grobeck, PA-C

  • Medical Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1144906330
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
9783 Issued in AZ
Practice address
4455 E Camelback Rd Ste 155
Phoenix, AZ 85018-2843
Phone
(480) 626-2444
NPI assigned
Jun 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X AZ
Medical Physician Assistant 363AM0700X 9783 AZ Primary

Addresses

Primary practice location

4455 E Camelback Rd Ste 155
Phoenix, AZ 85018-2843

Mailing address

4455 E Camelback Rd Ste 155
Phoenix, AZ 85018-2843
Phone (480) 626-2444

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
I20230809004082 AZ Practitioner - Physician Assistant 7517329477 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner - University Primary Care Physicians LLCGroup PAC ID 2365746450, 45 clinicians

Practice addresses (Care Compare)

1300 N 12TH St
Phoenix, AZ 85006-2849

Hospital & facility affiliations

  • Banner - University Medical Center Phoenix Hospital, Phoenix, AZ, CCN 030002

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Camelback Sports Therapy LLC PastSince Nov 1, 2015 Accepting new patients

Organizations & group practices 3

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 1

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": "1687478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1144906330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 E CAMELBACK RD STE 155",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182843",
            "telephone_number": "480-626-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 E CAMELBACK RD STE 155",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182843",
            "telephone_number": "480-626-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROBECK",
        "first_name": "DORY",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-23",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "9783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.