Individual provider Active NPI

Rachel Marie Cushman, PA-C

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1164994455
Registry record updated Dec 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7323 Issued in AZ
Practice address
8410 W Thomas Rd Ste 134
Phoenix, AZ 85037-3374
Phone
(623) 907-2377
NPI assigned
Dec 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2018

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 7323 AZ Primary

Addresses

Primary practice location

8410 W Thomas Rd Ste 134
Phoenix, AZ 85037-3374

Mailing address

915 E Valencia Dr
Phoenix, AZ 85042-6600
Phone (602) 820-7866

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
I20190401002399 AZ Practitioner - Physician Assistant 5193066157 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7323AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Banner - University Hospital Based Physicians LLC CurrentSince Feb 1, 2022 Accepting new patients
Banner - University Hospital Based Physicians LLC CurrentSince Feb 1, 2022 Accepting new patients
Sanford Medical Center Fargo Past Accepting new patients

Locations

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

Organizations & group practices 4

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": "1545782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545782400000",
    "number": "1164994455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 E VALENCIA DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850426600",
            "telephone_number": "602-820-7866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8410 W THOMAS RD STE 134",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850373374",
            "telephone_number": "623-907-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSHMAN",
        "first_name": "RACHEL",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-26",
        "last_updated": "2018-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "7323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.