Individual provider Active NPI

David O Netz, PA-C

  • Medical Physician Assistant
  • Show Low, AZ
National Provider Identifier
1407828528
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
3013 Issued in AZ
Practice address
4731 S White Mountian Rd
Show Low, AZ 85901
Phone
(928) 537-8777
Fax
(928) 537-1914
NPI assigned
Feb 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 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 3013 AZ Primary

Addresses

Primary practice location

4731 S White Mountian Rd
Show Low, AZ 85901

Mailing address

4830 Highway 260 Ste 103
Lakeside, AZ 85929-5851
Phone (928) 537-8777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060418000095 AZ Practitioner - Physician Assistant 9739198953 Reassigns benefits to 2 organizations
I20170223001886 WI Practitioner - Physician Assistant 9739198953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ian Brimhall PCGroup PAC ID 7517030281, 3 clinicians

Practice addresses (Care Compare)

2200 E Show Low Lake Rd
Show Low, AZ 85901-7831
Phone (928) 537-4375

4830 Hwy 260
Suite 103
Lakeside, AZ 85929-5851
Phone (928) 537-8777

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3013AZMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Healthcare Medical Associates Physician Assistant CurrentSince Aug 1, 2018 Accepting new patients
Summit Healthcare Medical Associates CurrentSince Aug 1, 2018 Accepting new patients
Summit Healthcare Medical Associates CurrentSince Aug 1, 2018 Accepting new patients

Locations

2200 E Show Low Lake Rd
Show Low, AZ 85901
Phone (928) 537-4375

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1407828528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4830 HIGHWAY 260 STE 103",
            "city": "LAKESIDE",
            "state": "AZ",
            "postal_code": "859295851",
            "telephone_number": "928-537-8777",
            "fax_number": "928-537-1914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4731 S WHITE MOUNTIAN RD",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "85901",
            "telephone_number": "928-537-8777",
            "fax_number": "928-537-1914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NETZ",
        "first_name": "DAVID",
        "middle_name": "O",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "3013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Show Low, AZ

Sources for this page

Verify at the official NPI Registry.