Individual provider Active NPI

My Thuong Thi Quirino, PA-C

  • Medical Physician Assistant
  • Mesa, AZ
National Provider Identifier
1245859115
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
8202 Issued in AZ
Practice address
6242 E Arbor Ave Ste 123
Mesa, AZ 85206-1309
Phone
(480) 930-4600
Fax
(480) 930-4615
NPI assigned
Apr 10, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 8202 AZ Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

6242 E Arbor Ave Ste 123
Mesa, AZ 85206-1309

Mailing address

6242 E Arbor Ave Ste 123
Mesa, AZ 85206-1309

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
I20201202001563 AZ Practitioner - Physician Assistant 8527479138 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner - University Super Specialists LLC 31 clinicians

Practice addresses (Care Compare)

1441 N 12TH St
FL 2
Phoenix, AZ 85006-2837
Phone (844) 242-4664

Hospital & facility affiliations

  • Banner - University Medical Center Phoenix Hospital, Phoenix, AZ, CCN 030002

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner - University Super Specialists LLC CurrentSince Dec 15, 2025 Accepting new patients

Locations

755 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 271-5111

1441 N 12th St
Fl 3
Phoenix, AZ 85006
Phone (602) 521-5700

1441 N 12th St
Fl 2
Phoenix, AZ 85006
Phone (602) 521-5180

Organizations & group practices 2

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": "1586476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1245859115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6242 E ARBOR AVE STE 123",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6242 E ARBOR AVE STE 123",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061309",
            "telephone_number": "480-930-4600",
            "fax_number": "480-930-4615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIRINO",
        "first_name": "MY THUONG",
        "middle_name": "THI",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-10",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "8202",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.