Individual provider Active NPI

Amber Mills

  • Medical Physician Assistant
  • Peoria, AZ
National Provider Identifier
1376254383
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
9960 Issued in AZ
Practice address
9059 W Lake Pleasant Pkwy Ste E540
Peoria, AZ 85382-8396
Phone
(623) 322-3380
NPI assigned
Dec 9, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2023

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 9960 AZ Primary

Addresses

Primary practice location

9059 W Lake Pleasant Pkwy Ste E540
Peoria, AZ 85382-8396

Mailing address

9059 W Lake Pleasant Pkwy Ste E540
Peoria, AZ 85382-8396
Phone (623) 322-3380

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
I20250529000276 AZ Order and Referring Only - Physician Assistant 4183143555

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9960AZMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pleasant Pediatrics PLC Past Accepting new patients
Pleasant Pediatrics PLC Past Accepting new patients
Pleasant Pediatrics PLC Past Accepting new patients
Pleasant Pediatrics PastSince Dec 6, 2022 Accepting new patients
Pleasant Pediatrics PLC PastSince Apr 1, 2021 Accepting new patients

Organizations & group practices 5

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": "1670544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1376254383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9059 W LAKE PLEASANT PKWY STE E540",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853828396",
            "telephone_number": "623-322-3380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9059 W LAKE PLEASANT PKWY STE E540",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853828396",
            "telephone_number": "623-322-3380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLS",
        "first_name": "AMBER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-09",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "9960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.