Individual provider Active NPI

Courtney Beutel Brincks Bandstra

  • Physician Assistant
  • Gilbert, AZ
National Provider Identifier
1366339970
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11388 Issued in AZ
Practice address
3645 S Rome St Ste 116
Gilbert, AZ 85297-7337
Phone
(480) 907-7551
NPI assigned
Jun 18, 2025
Last updated
Nov 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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 11388 AZ Primary

Addresses

Primary practice location

3645 S Rome St Ste 116
Gilbert, AZ 85297-7337

Mailing address

3645 S Rome St Ste 116
Gilbert, AZ 85297-7337
Phone (480) 907-7551

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
I20260209002050 AZ Practitioner - Physician Assistant 4981183100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Honorhealth AmbulatoryGroup PAC ID 5991603110, 630 clinicians

Practice addresses (Care Compare)

3645 S Rome St
Suite 116
Gilbert, AZ 85297-7337
Phone (480) 907-7551

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11388AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Honorhealth Ambulatory CurrentSince Dec 27, 2025 Accepting new patients
Honorhealth Ambulatory CurrentSince Dec 27, 2025 Accepting new patients
Honorhealth Ambulatory Past Accepting new patients

Locations

10320 W McDowell Rd
Ste 9030
Avondale, AZ 85392
Phone (480) 359-7384

3645 S Rome St
Ste 116
Gilbert, AZ 85297
Phone (480) 278-8300

10230 W Happy Valley Pkwy
Ste 200
Peoria, AZ 85383
Phone (480) 882-7465

10510 N 92nd St
Ste 200
Scottsdale, AZ 85258
Phone (480) 323-1250

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1750204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1366339970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3645 S ROME ST STE 116",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852977337",
            "telephone_number": "480-907-7551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3645 S ROME ST STE 116",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852977337",
            "telephone_number": "480-907-7551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINCKS BANDSTRA",
        "first_name": "COURTNEY",
        "middle_name": "BEUTEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-18",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "11388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.