NPIMap

Individual provider Active NPI

Elysia Small, PA

  • Medical Physician Assistant
  • Flagstaff, AZ
National Provider Identifier
1174074991
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
6563 Issued in AZ
Practice address
1501 S Yale St
Building 2 Suite 150
Flagstaff, AZ 86001-7304
Phone
(928) 527-4325
Fax
(928) 527-4327
NPI assigned
Oct 17, 2016
Last updated
Jul 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 6563 AZ Primary

Addresses

Primary practice location

1501 S Yale St
Building 2 Suite 150
Flagstaff, AZ 86001-7304

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 954-7761

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161221000964 AZ Practitioner - Physician Assistant 3072894591 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ryan Internal Medicine PCGroup PAC ID 4082613708, 5 clinicians

Practice addresses (Care Compare)

1350 N Rim Dr
Flagstaff, AZ 86001-3111
Phone (928) 213-5881

5830 N 19TH Ave
Phoenix, AZ 85015-2494
Phone (602) 336-1966

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ryan Internal Medicine PC CurrentSince Nov 17, 2025 Accepting new patients
Greater Phoenix Collaborative Care PC CurrentSince Jun 1, 2024 Accepting new patients

Locations

107 E Oak Ave
Ste 202
Flagstaff, AZ 86001
Phone (928) 213-8631

1350 N Rim Dr
Flagstaff, AZ 86001
Phone (928) 213-5881

1501 S Yale St
Ste 150
Flagstaff, AZ 86001
Phone (928) 527-4325

2001 N 4th St
Flagstaff, AZ 86004
Phone (928) 526-5020

5830 N 19th Ave
Phoenix, AZ 85015
Phone (602) 249-0115

1460 W Valencia Rd
Tucson, AZ 85746
Phone (520) 573-0966

4730 E Grant Rd
Tucson, AZ 85712
Phone (520) 290-0300

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CFIEAA
  • FHIR API: https://fhir4.healow.com/fhir/r4/CFIEAA/Endpoint/CFIEAA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1174074991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-954-7761",
            "fax_number": "928-527-4327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S YALE ST",
            "address_2": "BUILDING 2 SUITE 150",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860017304",
            "telephone_number": "928-527-4325",
            "fax_number": "928-527-4327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALL",
        "first_name": "ELYSIA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-17",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "6563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.