Carla Boan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

7243 Issued in AZ

Practice address

20440 N 27TH Ave
Phoenix, AZ 85027-3240

Phone

(480) 882-4545

NPI assigned

Sep 4, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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

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.

• District Medical Group, Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Phoenix, AZ
  • NPI 1336472448
  Medicare reassignment
• Maricopa County Special Health Care District

  dba Valleywise Health

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1073576740
  Medicare reassignment
• District Medical Group, Inc

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1144624339
  NPD
• District Medical Group, Inc

  dba DMG

  • Rheumatology Physician
  • Phoenix, AZ
  • NPI 1538484993
  NPD
• Maricopa County Special Health Care District

  dba Maricopa Special Health Care District

  • Adult Mental Health Clinic/Center
  • Mesa, AZ
  • NPI 1003273855
  NPD
• Maricopa County Special Health Care District

  dba Maricopa Integrated Heatlh

  • Federally Qualified Health Center (FQHC)
  • Mesa, AZ
  • NPI 1306265145
  NPD
• Neighborhood Outreach Access to Health

  dba Copperwood II Health Center

  • Federally Qualified Health Center (FQHC)
  • Glendale, AZ
  • NPI 1326731555
  NPD
• Neighborhood Outreach Access to Health

  • Family Medicine Physician
  • Scottsdale, AZ
  • NPI 1942518550
  NPD
• District Medical Group, Inc

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1295968162
  NPD (past)

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

{
    "created_epoch": "1536019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1164904413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 N DREAMY DRAW DR STE 145",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204668",
            "telephone_number": "480-882-4545",
            "fax_number": "480-882-5814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20440 N 27TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850273240",
            "telephone_number": "480-882-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOAN",
        "first_name": "CARLA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-04",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "7243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "453058",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vilawoe Aku Boadu, RPHPHARMD
• Charles Brixner Boag Jr., DC
• Charles Brixner Boag III, D.O.
• Heather Nicole Akyea Boakye-Wenzel, MD
• Lisette Danielle Boal, M.S., CCC-SLP
• Imani Board
• Boardman Family Chiropractic, P.C.
• Nicole Josette Boardman Mitcham, MD, MPH
• John E Boardman, D.C.
• David Michael Boarman, MSC LPC LISAC

• Physician Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.