Individual provider Active NPI

Mariah L Trerise, PA-C

  • Physician Assistant
  • Scottsdale, AZ
National Provider Identifier
1174247787
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9348 Issued in AZ
Practice address
13400 E Shea Blvd
Scottsdale, AZ 85259-5499
Phone
(480) 301-8000
NPI assigned
Sep 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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 9348 AZ Primary

Addresses

Primary practice location

13400 E Shea Blvd
Scottsdale, AZ 85259-5499

Mailing address

14044 W Camelback Rd Ste 204
Litchfield Park, AZ 85340-9426
Phone (623) 935-9600

Other names 1

  • Mariah Wilson Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mtrerise2533265@ehrdirect.mayoclinicmsg.org

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
I20221013000475 AZ Practitioner - Physician Assistant 5698141810 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Arizona College of Osteopathic Medicine Mid Western University, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mayo Clinic ArizonaGroup PAC ID 7012829930, 1,618 clinicians

Practice addresses (Care Compare)

13400 E Shea Blvd
Scottsdale, AZ 85259-5404
Phone (480) 301-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9348AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Arizona CurrentSince Aug 13, 2025 Accepting new patients
Mayo Clinic Arizona CurrentSince Aug 13, 2025 Accepting new patients
Pinnacle Family Medicine PLC PastSince Sep 5, 2023 Accepting new patients

Locations

13400 E Shea Blvd
Scottsdale, AZ 85259

Interoperability endpoints

  • Direct secure messaging: mtrerise2533265@ehrdirect.mayoclinicmsg.org

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.

Hospital & facility affiliations 1

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": "1664236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1174247787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14044 W CAMELBACK RD STE 204",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853409426",
            "telephone_number": "623-935-9600",
            "fax_number": "623-935-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852595499",
            "telephone_number": "480-301-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRERISE",
        "first_name": "MARIAH",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-27",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "9348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mtrerise2533265@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "13400 E Shea Blvd",
            "city": "Scottsdale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852595499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARIAH",
            "last_name": "WILSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.