Individual provider Active NPI

Stephanie Maurer

  • Medical Physician Assistant
  • Prescott, AZ
National Provider Identifier
1275004186
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
3108 Clearwater Dr Ste a
Prescott, AZ 86305-7170
Phone
(217) 877-9117
NPI assigned
Dec 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X AZ Primary

Addresses

Primary practice location

3108 Clearwater Dr Ste a
Prescott, AZ 86305-7170

Mailing address

415 Torrey Pine LN
Prescott, AZ 86301-4101
Phone (406) 498-1199

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
I20210413001726 AZ Practitioner - Physician Assistant 0648688614 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prescott Complete Care, PLLCGroup PAC ID 3476982224, 5 clinicians

Practice addresses (Care Compare)

1947 Commerce Ctr Cir
Suite a
Prescott, AZ 86301-4500
Phone (928) 458-5723

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8346AZMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Kenneth G. Lawlor, DO, PLLC CurrentSince Apr 5, 2021 Accepting new patients
Allergy & Immunology Specialists, LLC Past Accepting new patients

Locations

1355 W White Mountain Blvd
Ste A
Lakeside, AZ 85929
Phone (928) 358-4086

2060 W Whispering Wind Dr
Ste 264
Phoenix, AZ 85085
Phone (623) 235-6889

3108 Clearwater Dr
Ste A
Prescott, AZ 86305
Phone (928) 717-0788

Interoperability endpoints

  • Direct secure messaging: stephanie.maurer.d1.p1@direct.prescottrheum.nextgenshare.com

Organizations & group practices 4

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": "1545004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1275004186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 TORREY PINE LN",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863014101",
            "telephone_number": "406-498-1199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3108 CLEARWATER DR STE A",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863057170",
            "telephone_number": "217-877-9117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURER",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-17",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.