Individual provider Active NPI

Samuel Varosky, PA-C

  • Physician Assistant
  • Mesa, AZ
National Provider Identifier
1215448519
Registry record updated Nov 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
6553 E Baywood Ave
Mesa, AZ 85206-1752
Phone
(480) 543-6750
Fax
(480) 543-5907
NPI assigned
Oct 13, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 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 Primary

Addresses

Primary practice location

6553 E Baywood Ave
Mesa, AZ 85206-1752

Mailing address

341 W Wilshire Dr
Phoenix, AZ 85003-1026

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
I20180406002129 AZ Practitioner - Physician Assistant 1658630017 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10401 W Thunderbird Blvd
Sun City, AZ 85351-3004
Phone (623) 832-4000

1125 S Alma School Rd
Suite 210
Chandler, AZ 85286-2811
Phone (480) 733-7300

6644 E Baywood Ave
Banner Health Clinic
Mesa, AZ 85206-1747
Phone (480) 321-2000

9165 W Thunderbird Rd
Suite 200
Peoria, AZ 85381-4847
Phone (623) 285-1120

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Physician Specialists Arizona LLC CurrentSince Nov 5, 2018 Accepting new patients
Banner Primary Care Physicians Arizona LLC CurrentSince Mar 1, 2020 Accepting new patients
Banner Physician Specialists Arizona LLC Current Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Nov 5, 2018 Accepting new patients

Locations

1125 S Alma School Rd
Ste 210
Chandler, AZ 85286
Phone (480) 256-4900

1920 N Higley Rd
Ste 206
Gilbert, AZ 85234
Phone (480) 543-6700

1900 N Higley Rd
Gilbert, AZ 85234
Phone (480) 543-2000

6553 E Baywood Ave
Ste 101
Mesa, AZ 85206
Phone (480) 543-6750

1917 S Crismon Rd
Mesa, AZ 85209
Phone (480) 610-7100

2225 W Southern Ave
Mesa, AZ 85202
Phone (480) 412-4101

120 E Main St
Ste A
Payson, AZ 85541
Phone (928) 474-9744

13640 N Plaza del Rio Blvd
Peoria, AZ 85381
Phone (623) 876-3800

9165 W Thunderbird Rd
Ste 200
Peoria, AZ 85381
Phone (623) 285-1120

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

37000 N Gantzel Rd
San Tan Valley, AZ 85140
Phone (480) 394-4000

37100 N Gantzel Rd
Ste 107
San Tan Vly, AZ 85140
Phone (480) 394-4480

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

Organizations & group practices 5

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 2

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": "1507852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541635200000",
    "number": "1215448519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 W WILSHIRE DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850031026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6553 E BAYWOOD AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061752",
            "telephone_number": "480-543-6750",
            "fax_number": "480-543-5907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAROSKY",
        "first_name": "SAMUEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-13",
        "last_updated": "2018-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.