Individual provider Active NPI

Michael Dobbins, PA-C

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1376145789
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8259 Issued in AZ
Practice address
12020 S Warner Elliot Loop Ste 101
Phoenix, AZ 85044-2712
Phone
(480) 751-1900
NPI assigned
Nov 10, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 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 8259 AZ Primary

Addresses

Primary practice location

12020 S Warner Elliot Loop Ste 101
Phoenix, AZ 85044-2712

Mailing address

12020 S Warner Elliot Loop Ste 101
Phoenix, AZ 85044-2712
Phone (480) 751-1900

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
I20231213003149 AZ Practitioner - Physician Assistant 8123477338 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8259AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America-Arizona, PC CurrentSince Apr 1, 2025 Accepting new patients
Whispering Palms Medical Inc Past Accepting new patients

Locations

1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1604966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1376145789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12020 S WARNER ELLIOT LOOP STE 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850442712",
            "telephone_number": "480-751-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12020 S WARNER ELLIOT LOOP STE 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850442712",
            "telephone_number": "480-751-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBBINS",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-10",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "8259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.