Arizona Surgical Assistants, LLC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

3740 Issued in AZ

Legal business name

ARIZONA SURGICAL ASSISTANTS, LLC

Practice address

5555 W Thunderbird Rd
Glendale, AZ 85306-4622

Phone

(623) 865-5555

Fax

(480) 478-6628

NPI assigned

Jul 10, 2014

Last updated

Dec 19, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark Mitchell, PA-C

Title

Owner/Manager

Phone

(480) 256-1518

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1404950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418947200000",
    "number": "1265848105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8424 E SHEA BLVD",
            "address_2": "#101",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852606662",
            "telephone_number": "480-256-1518",
            "fax_number": "480-478-6628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 W THUNDERBIRD RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064622",
            "telephone_number": "623-865-5555",
            "fax_number": "480-478-6628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA SURGICAL ASSISTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-10",
        "last_updated": "2014-12-19",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "480-256-1518",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "3740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Surgical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.