Active NPI
Daniel Joseph Mizell, PA-C
- Physician Assistant
- Surprise, AZ
National Provider Identifier
1376141515
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 8196
- Practice address
- 12665 W Smokey Dr Ste 140
Surprise, AZ 85378-3732 - Phone
- (623) 219-4040
- NPI assigned
- Oct 10, 2020
- Last updated
- Feb 13, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 8196 | AZ | Primary |
Addresses
Primary practice location
12665 W Smokey Dr Ste 140
Surprise, AZ 85378-3732
Mailing address
5601 W Eugie Ave Ste 100
Glendale, AZ 85304-1256
Phone (602) 298-8888
Other practice location 1
18699 N 67th Ave Ste 120
Glendale, AZ 85308-7141
Phone (602) 298-8888
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8196 | AZ | MD | Physical Therapist |
Interoperability endpoints
- daniel.mizell.p32@direct.aara1.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676246400000",
"number": "1376141515",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5601 W EUGIE AVE STE 100",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853041256",
"telephone_number": "602-298-8888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12665 W SMOKEY DR STE 140",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853783732",
"telephone_number": "623-219-4040"
}
],
"practiceLocations": [
{
"address_1": "18699 N 67th Ave Ste 120",
"address_purpose": "LOCATION",
"city": "Glendale",
"state": "AZ",
"postal_code": "853087141",
"country_code": "US",
"telephone_number": "602-298-8888",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MIZELL",
"first_name": "DANIEL",
"middle_name": "JOSEPH",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-10-10",
"last_updated": "2023-02-13",
"certification_date": "2023-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "8196",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Surprise, AZ
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- Aaron M Mitchell
- Abigail Mitroff, PA-C
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.