Individual provider Active NPI

Jordan Schenk, PA-C

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1154906782
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8407 Issued in AZ
Practice address
202 E Earll Dr Ste 360
Phoenix, AZ 85012-2677
Phone
(480) 788-5621
NPI assigned
Mar 15, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 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 8407 AZ Primary

Addresses

Primary practice location

202 E Earll Dr Ste 360
Phoenix, AZ 85012-2677

Mailing address

11685 W Massingale Rd
Tucson, AZ 85743-9408
Phone (208) 709-6462

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
I20210409001104 AZ Practitioner - Physician Assistant 7517375652 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner Urgent Care Services LLCGroup PAC ID 4284921610, 207 clinicians
Banner Urgent Care Arizona LLCGroup PAC ID 3678749496, 47 clinicians

Practice addresses (Care Compare)

10330 N Scottsdale Rd
Suite 25
Scottsdale, AZ 85253-1427
Phone (602) 255-7625

1215 S Higley Rd
Mesa, AZ 85206-3486
Phone (480) 827-5740

1660 N Higley Rd
Suite 104
Gilbert, AZ 85234-1615
Phone (480) 827-5600

1676 E McMurray Blvd
Suite 1
Casa Grande, AZ 85122-4798
Phone (520) 316-0688

1908 E McKellips Rd
Mesa, AZ 85203-2866
Phone (480) 827-5610

1955 W Guadalupe Rd
Suite 101 102
Mesa, AZ 85202-7487
Phone (480) 827-5620

3141 S McClintock Dr
Suite 1
Tempe, AZ 85282-5682
Phone (480) 827-5650

3160 E Queen Creek Rd
Gilbert, AZ 85297-8403
Phone (480) 827-5790

35945 N Gary Rd
San Tan Valley, AZ 85143-5748
Phone (480) 827-5750

40773 N Ironwood Dr
San Tan Valley, AZ 85140-7002
Phone (480) 827-5760

4232 W Bell Rd
Glendale, AZ 85308-4027
Phone (623) 465-6360

641 W Warner Rd
Gilbert, AZ 85233-7266
Phone (480) 827-5680

9111 N 7TH St
Phoenix, AZ 85020-2515
Phone (602) 255-7670

931 E Elliot Rd
Suite 115
Tempe, AZ 85284-1583
Phone (480) 827-5640

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Urgent Care Services, LLC CurrentSince Jan 1, 2024 Accepting new patients
Banner Urgent Care Services, LLC CurrentSince Jan 1, 2024 Accepting new patients
Advanced Minimally Invasive Surgical CurrentSince Mar 8, 2021 Accepting new patients
Banner Urgent Care Arizona LLC CurrentSince Feb 1, 2024 Accepting new patients

Locations

1676 E McMurray Blvd
Ste 1
Casa Grande, AZ 85122
Phone (520) 316-0688

1455 W Chandler Blvd
Ste B11
Chandler, AZ 85224
Phone (480) 917-9208

3000 N Arizona Ave
Chandler, AZ 85225
Phone (480) 355-1575

1955 W Guadalupe Rd
Ste 1
Mesa, AZ 85202
Phone (480) 207-2990

1120 S Gilbert Rd
Mesa, AZ 85204
Phone (480) 558-5278

1121 S Gilbert Rd
Ste 101
Mesa, AZ 85204
Phone (480) 644-9355

5060 N 19th Ave
Ste 207
Phoenix, AZ 85015
Phone (480) 488-5621

202 E Earll Dr
Ste 360
Phoenix, AZ 85012
Phone (480) 323-6072

4760 E Thunderbird Rd
Ste 1
Phoenix, AZ 85032
Phone (480) 827-5590

35945 N Gary Rd
San Tan Valley, AZ 85143
Phone (480) 827-5750

10330 N Scottsdale Rd
Ste 25
Scottsdale, AZ 85253
Phone (602) 255-7625

7066 E Golf Links Rd
Tucson, AZ 85730
Phone (520) 514-0344

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1615766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1154906782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11685 W MASSINGALE RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857439408",
            "telephone_number": "208-709-6462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E EARLL DR STE 360",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122677",
            "telephone_number": "480-788-5621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHENK",
        "first_name": "JORDAN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-15",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "8407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.