Individual provider Active NPI

Santiago A Chavez, PA

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1295811677
Registry record updated Sep 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
TEMPORARY LICENSE Issued in TX
Practice address
3811 E Bell Rd Ste 309
Phoenix, AZ 85032-2160
Phone
(480) 420-0749
Fax
(480) 420-0732
NPI assigned
Oct 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2019

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 TEMPORARY LICENSE TX Primary

Addresses

Primary practice location

3811 E Bell Rd Ste 309
Phoenix, AZ 85032-2160

Mailing address

3811 E Bell Rd Ste 309
Phoenix, AZ 85032-2160
Phone (480) 420-0749

Other practice location 1

3100 N Lee Trevino Dr Ste B
El Paso, TX 79936
Phone (915) 533-7465

Other identifiers 1

IdentifierTypeStateIssuer
208169703MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070228000349 TX Practitioner - Physician Assistant 7911009584 Reassigns benefits to 1 organization
I20191003003601 AZ Practitioner - Physician Assistant 7911009584 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
VHS Outpatient Clinics IncGroup PAC ID 4486566726, 206 clinicians

Practice addresses (Care Compare)

1840 S Stapley Dr
Suite 137
Mesa, AZ 85204-6683
Phone (480) 558-3744

3929 E Bell Rd
Phoenix, AZ 85032-2112
Phone (602) 274-6506

5130 W Baseline Rd
Suite 102
Laveen, AZ 85339-2984
Phone (602) 237-0039

708 S Coeur D Alene LN
Suite 100
Payson, AZ 85541-5662
Phone (928) 472-7440

708 S Coeur D'Alene Lane
Suite a
Payson, AZ 85541-5662
Phone (602) 726-8805

708 S Coeur D'Alene LN
Payson, AZ 85541-5662
Phone (928) 474-2175

Hospital & facility affiliations

  • Abrazo Scottsdale Campus Hospital, Phoenix, AZ, CCN 030083

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
BHS Physicians Network, Inc CurrentSince Dec 24, 2018 Accepting new patients
BHS Physicians Network, Inc CurrentSince Dec 24, 2018 Accepting new patients
VHS Outpatient Clinics, Inc. CurrentSince Jul 21, 2019 Accepting new patients

Locations

5130 W Baseline Rd
Ste 102
Laveen, AZ 85339
Phone (602) 237-0039

1840 S Stapley Dr
Ste 137
Mesa, AZ 85204
Phone (602) 952-0002

708 S Coeur D Alene Ln
Ste 100
Payson, AZ 85541
Phone (928) 472-7440

26900 N Lake Pleasant Pkwy
Ste 210
Peoria, AZ 85383
Phone (623) 561-3000

2122 E Highland Ave
Ste 100
Phoenix, AZ 85016
Phone (480) 372-2111

3929 E Bell Rd
Phoenix, AZ 85032
Phone (602) 923-5000

3811 E Bell Rd
Ste 309
Phoenix, AZ 85032
Phone (480) 420-0749

8630 E Via de Ventura
Ste 201
Scottsdale, AZ 85258
Phone (214) 556-3227

1700 Murchison Dr
El Paso, TX 79902
Phone (915) 534-1124

3100 N Lee Trevino Dr
Ste B
El Paso, TX 79936
Phone (915) 843-4776

3903 Wiseman Blvd
San Antonio, TX 78251
Phone (210) 681-0126

Interoperability endpoints

  • Direct secure messaging: santiago.chavez.1@1438.direct.athenahealth.com
  • Direct secure messaging: santiago.chavez.1@600.direct.athenahealth.com

Organizations & group practices 3

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": "1161993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567555200000",
    "number": "1295811677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3811 E BELL RD STE 309",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322160",
            "telephone_number": "480-420-0749",
            "fax_number": "480-420-0732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3811 E BELL RD STE 309",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322160",
            "telephone_number": "480-420-0749",
            "fax_number": "480-420-0732"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 N Lee Trevino Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "79936",
            "country_code": "US",
            "telephone_number": "915-533-7465",
            "fax_number": "915-534-1185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAVEZ",
        "first_name": "SANTIAGO",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-28",
        "last_updated": "2019-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "TEMPORARY LICENSE",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208169703",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.