Jamie Lee Anderson, PA-C
Individual provider Active NPI Surgical Physician Assistant · Gilbert, AZ
NPI 1154896058 · NPPES record last updated May 8, 2024
Key facts
- NPI
- 1154896058
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Physician Assistant 363AS0400X
- License
- 7301 (AZ)
- Practice address
- 2946 E Banner Gateway Dr
Gilbert, AZ 85234 - Phone
- (480) 256-6444
- Fax
- (480) 256-3682
- NPI assigned
- Oct 6, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Banner Cancer Center Specialists LLC
Practice addresses (Care Compare)
1900 N Higley Rd
Gilbert, AZ 85234-1604
Phone (480) 543-2000
2946 E Banner Gateway Dr
Gilbert, AZ 85234-2165
Phone (480) 256-6444
Hospital & facility affiliations
- Banner Gateway Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190109001515 | AZ | Practitioner - Physician Assistant | 9931445152 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Banner Cancer Center Specialists LLC | Current |
Accepting new patients | |
| VHS Outpatient Clinics, Inc. | Current |
Accepting new patients |
Locations
2946 E Banner Gateway Dr
Rm 2008
Gilbert, AZ 85234
Phone (480) 256-4523
2946 E Banner Gateway Dr
Gilbert, AZ 85234
Phone (480) 256-5450
1900 N Higley Rd
Gilbert, AZ 85234
Phone (480) 543-2000
5130 W Baseline Rd
Ste 102
Laveen, AZ 85339
Phone (602) 237-0039
3811 E Bell Rd
Ste 300
Phoenix, AZ 85032
Phone (480) 454-7350
2000 W Bethany Home Rd
Phoenix, AZ 85015
Phone (480) 209-4000
1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000
925 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-4498
10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690
10424 W Santa Fe Dr
Sun City, AZ 85351
Phone (623) 832-3400
14416 W Meeker Blvd
Ste 301
Sun City West, AZ 85375
Phone (623) 876-3800
14502 W Meeker Blvd
Sun City West, AZ 85375
Phone (623) 214-4000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 7301 | AZ | Yes |
Addresses
Primary practice location
2946 E Banner Gateway Dr
Gilbert, AZ 85234
Mailing address
2940 E. Banner Gatway Dr
Suite 450
Gilbert, AZ 85234
Phone (480) 256-6444
Other names
- Jamie Lee Boma
Other providers in Gilbert, AZ
- Ashli Laraine Anderson
- Christopher Samuel Anderson
- Darlene K Anderson
- Fallon Anderson
- James T Anderson
- Kimberly Ann Anderson
- Kristin Marie Anderson
- Mary Elise Anderson
- Matthew Anderson
- Megan Maedee Anderson
All providers in Gilbert, AZ · Surgical Physician Assistant in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.