Individual provider Active NPI

Randy Dee Danielsen, PA-C

  • Medical Physician Assistant
  • Scottsdale, AZ
National Provider Identifier
1356656342
Registry record updated Aug 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1081 Issued in AZ
Practice address
9220 E Mountain View Rd
Suite 200
Scottsdale, AZ 85258-5133
Phone
(480) 451-6756
Fax
(480) 451-8679
NPI assigned
Aug 13, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2010

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 1081 AZ Primary

Addresses

Primary practice location

9220 E Mountain View Rd
Suite 200
Scottsdale, AZ 85258-5133

Mailing address

428 S Gilbert Rd
Suite 109
Gilbert, AZ 85296-2263
Phone (480) 633-3639

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Asthma Allergy Legacy PLC Physician Assistant PastSince Oct 31, 2021 Accepting new patients
Arizona Asthma & Allergy Institute LTD Physician Assistant PastSince Jul 23, 2007 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.60978

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": "1281657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281657600000",
    "number": "1356656342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 S GILBERT RD",
            "address_2": "SUITE 109",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852962263",
            "telephone_number": "480-633-3639",
            "fax_number": "888-372-6991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9220 E MOUNTAIN VIEW RD",
            "address_2": "SUITE 200",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852585133",
            "telephone_number": "480-451-6756",
            "fax_number": "480-451-8679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELSEN",
        "first_name": "RANDY",
        "middle_name": "DEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-13",
        "last_updated": "2010-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "1081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2010; 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.