Loren Eberhard, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4214 Issued in AZ

Practice address

1425 S. Greenfield Rd Ste 101
Mesa, AZ 85206

Phone

(480) 981-3000

Fax

(480) 325-3614

NPI assigned

Aug 15, 2008

Last updated

Aug 15, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Summit Medical Group Arizona LLCGroup PAC ID 3173872835, 152 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: loren.eberhard.1@19654.direct.athenahealth.com

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.

• Summit Medical Group Arizona LLC

  • Family Medicine Physician
  • Glendale, AZ
  • NPI 1053810622
  Medicare reassignment Care Compare group
• Deseret Family Practice, LTD.

  dba Deseret Family Medicine

  • Multi-Specialty Clinic/Center
  • Mesa, AZ
  • NPI 1215960638
  NPD (past)
• Nsobi PLLC

  • Sports Medicine (Family Medicine) Physician
  • Mesa, AZ
  • NPI 1912518044
  NPD (past)

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

{
    "created_epoch": "1218758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218758400000",
    "number": "1225284755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 S. GREENFIELD RD #101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85206",
            "telephone_number": "480-981-3000",
            "fax_number": "480-325-3614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 S. GREENFIELD RD STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85206",
            "telephone_number": "480-981-3000",
            "fax_number": "480-325-3614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERHARD",
        "first_name": "LOREN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-15",
        "last_updated": "2008-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "4214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aphrodite Easton, MSW
• Eastridge Family Dentistry, Inc.
• Erika M Eastwood, M.S., CCC-SLP
• Jake Eastwood, COTA/L
• Vicki Lee Eaton, LCSW
• Lori Christine Ebert, PHD
• Cena Ebling, LPN
• Alexandra Katherine Ebong, DNP, FNP-C
• Farid Ebrahim, D.D.S.
• Lorraine Edythe Ebright, MC MASTERS IN COUNSE

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.