Active NPI
Heidi Gabrielle Grodman
- Physician Assistant
- Mesa, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 11523
- Practice address
- 1400 S Dobson Rd
Mesa, AZ 85202-4707 - Phone
- (480) 412-3000
- NPI assigned
- Mar 4, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 11523 | AZ | Primary |
Addresses
Primary practice location
1400 S Dobson Rd
Mesa, AZ 85202-4707
Mailing address
1400 S Dobson Rd
Mesa, AZ 85202-4707
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1520 S Dobson Rd
Suite 203
Mesa, AZ 85202-4726
Phone (480) 733-7535
Hospital & facility affiliations
- Banner Desert Medical Center
- Beaumont Hospital - Farmington Hills
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11523 | AZ | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Banner Physician Specialists Arizona LLC | Current | Accepting new patients | |
| Banner Physician Specialists Arizona LLC | Current | Accepting new patients |
Locations
1125 S Alma School Rd
Ste 310
Chandler, AZ 85286
Phone (480) 684-6157
1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000
1520 S Dobson Rd
Ste 203
Mesa, AZ 85202
Phone (480) 412-8080
6424 E Broadway Rd
Ste 105
Mesa, AZ 85206
Phone (480) 248-3000
9165 W Thunderbird Rd
Ste 200
Peoria, AZ 85381
Phone (623) 285-1120
Interoperability endpoints
- hgrodman3399673@epic00.corewelldirect.org
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.
-
- Multi-Specialty Clinic/Center
- Phoenix, AZ
- NPI 1821368218
-
- Multi-Specialty Clinic/Center
- Page, AZ
- NPI 1366799355
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Mesa, AZ
- NPI 1720011810
-
- General Acute Care Hospital
- Farmington Hills, MI
- NPI 1336183367
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1709510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769472000000",
"number": "1265299507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 S DOBSON RD",
"city": "MESA",
"state": "AZ",
"postal_code": "852024707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 S DOBSON RD",
"city": "MESA",
"state": "AZ",
"postal_code": "852024707",
"telephone_number": "480-412-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRODMAN",
"first_name": "HEIDI",
"middle_name": "GABRIELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-04",
"last_updated": "2026-01-27",
"certification_date": "2026-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "11523",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2026; 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.