Individual provider Active NPI

Nicholas Richard Barrett, P.A.

  • Physician Assistant
  • Oro Valley, AZ
National Provider Identifier
1326304239
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10934 Issued in AZ
Practice address
1551 E Tangerine Rd
Oro Valley, AZ 85755-6213
Phone
(520) 901-3500
Fax
(659) 235-6176
NPI assigned
Apr 4, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601006350 MI
Physician Assistant 363A00000X PA11042 TX
Physician Assistant 363A00000X 10934 AZ Primary

Addresses

Primary practice location

1551 E Tangerine Rd
Oro Valley, AZ 85755-6213

Mailing address

38935 Ann Arbor Rd
Credentialing Dept
Livonia, MI 48150-3397
Phone (734) 632-0175

Other practice location 1

33155 Annapolis St
Emergency Dept
Wayne, MI 48184-2405
Phone (734) 467-4042

Other identifiers 1

IdentifierTypeStateIssuer
12403275OtherMICAQH

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
I20170207002060 TX Practitioner - Physician Assistant 7719135359 Reassigns benefits to 1 organization
I20250203002944 AZ Practitioner - Physician Assistant 7719135359 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lakes Urgent Care Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: nbarrett220626@direct.hfhs.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1326304239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38935 ANN ARBOR RD",
            "address_2": "CREDENTIALING DEPT",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481503397",
            "telephone_number": "734-632-0175",
            "fax_number": "866-250-6385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 E TANGERINE RD",
            "city": "ORO VALLEY",
            "state": "AZ",
            "postal_code": "857556213",
            "telephone_number": "520-901-3500",
            "fax_number": "659-235-6176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "33155 Annapolis St",
            "address_2": "Emergency Dept",
            "address_purpose": "LOCATION",
            "city": "Wayne",
            "state": "MI",
            "postal_code": "481842405",
            "country_code": "US",
            "telephone_number": "734-467-4042",
            "fax_number": "734-467-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARRETT",
        "first_name": "NICHOLAS",
        "middle_name": "RICHARD",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-04",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006350",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA11042",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "10934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12403275",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oro Valley, AZ

Sources for this page

Verify at the official NPI Registry.