Individual provider Active NPI

Randy Jay, P.A.

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1285707760
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1349 Issued in AZ
Practice address
4550 E Bell Rd Ste 170
Phoenix, AZ 85032-9385
Phone
(480) 443-8400
Fax
(480) 443-8697
NPI assigned
Nov 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1349 AZ Primary

Addresses

Primary practice location

4550 E Bell Rd Ste 170
Phoenix, AZ 85032-9385

Mailing address

4550 E. Bell Road
Suite 170
Phoenex, AZ 85032
Phone (480) 443-8400

Other identifiers 1

IdentifierTypeStateIssuer
1349OtherAZSTATE MEDICAL LICENSE - PA

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
I20050117000166 AZ Practitioner - Physician Assistant 4082663034 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1349AZMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Arthritis and Rheumatology Associates CurrentSince Dec 1, 2004 Accepting new patients

Locations

4550 E Bell Rd
Ste 170
Phoenix, AZ 85032
Phone (460) 443-8400

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.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1285707760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 E. BELL ROAD",
            "address_2": "SUITE 170",
            "city": "PHOENEX",
            "state": "AZ",
            "postal_code": "85032",
            "telephone_number": "480-443-8400",
            "fax_number": "480-443-8697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 E BELL RD STE 170",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850329385",
            "telephone_number": "480-443-8400",
            "fax_number": "480-443-8697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAY",
        "first_name": "RANDY",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "1349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE - PA",
            "identifier": "1349",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.