Individual provider Active NPI

Weston Debry, PA-C

  • Physician Assistant
  • Peoria, AZ
National Provider Identifier
1417310657
Registry record updated Nov 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6703 Issued in AZ
Practice address
13460 N 94TH Dr Ste J1
Peoria, AZ 85381-4246
Phone
(623) 876-8816
Fax
(623) 298-0168
NPI assigned
Apr 4, 2016
Last updated
Nov 7, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 53246 CA
Physician Assistant 363A00000X 6703 AZ Primary

Addresses

Primary practice location

13460 N 94TH Dr Ste J1
Peoria, AZ 85381-4246

Mailing address

13460 N 94TH Dr Ste J1
Peoria, AZ 85381-4246
Phone (623) 876-8816

Other identifiers 1

IdentifierTypeStateIssuer
6703OtherAZAZ PA LICENSE

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
I20170719002101 AZ Practitioner - Physician Assistant 8224308515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Joseph a Caplan MD PCGroup PAC ID 5890687842, 30 clinicians

Practice addresses (Care Compare)

14420 W Meeker Blvd
Suite 305
Sun City West, AZ 85375-5289
Phone (623) 876-8816

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6703AZMDPhysician Assistant
53246CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiac Care Consultants, PC Past Accepting new patients

Organizations & group practices 2

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": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1417310657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13460 N 94TH DR STE J1",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814246",
            "telephone_number": "623-876-8816",
            "fax_number": "623-298-0168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13460 N 94TH DR STE J1",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814246",
            "telephone_number": "623-876-8816",
            "fax_number": "623-298-0168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBRY",
        "first_name": "WESTON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-04",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "53246",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ PA LICENSE",
            "identifier": "6703",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.