Individual provider Active NPI

Michelle Nemeh

  • Physician Assistant
  • Glendale, AZ
National Provider Identifier
1417413337
Registry record updated Jul 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7328 Issued in AZ
Practice address
5310 W Thunderbird Rd Ste 203
Glendale, AZ 85306-4712
Phone
(480) 292-8488
Fax
(480) 292-8292
NPI assigned
Feb 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2023

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 7328 AZ Primary

Addresses

Primary practice location

5310 W Thunderbird Rd Ste 203
Glendale, AZ 85306-4712

Mailing address

31938 Temecula Pkwy Ste A337
Temecula, CA 92592-6810
Phone (866) 270-0062

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
I20200221002260 AZ Practitioner - Physician Assistant 7315374808 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Dermatology PLLCGroup PAC ID 4183148919, 2 clinicians
Southwest Skin Specialists LLCGroup PAC ID 9739079864, 51 clinicians

Practice addresses (Care Compare)

1121 S Gilbert Rd
Suite 102
Mesa, AZ 85204-5235
Phone (623) 937-8969

14537 W Indian School Rd
Suite 700
Goodyear, AZ 85395-9243
Phone (623) 935-0247

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7328AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Skin Specialists, LLC CurrentSince Mar 26, 2026 Accepting new patients
Southwest Skin Specialists LLC Past Accepting new patients
Valley Primary Care Physicians, LLC Past Accepting new patients

Locations

14537 W Indian School Rd
#700
Goodyear, AZ 85395
Phone (623) 935-0247

10200 N 92nd St
Ste 205
Scottsdale, AZ 85258
Phone (602) 494-1817

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": "1550188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1417413337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31938 TEMECULA PKWY STE A337",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925926810",
            "telephone_number": "866-270-0062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5310 W THUNDERBIRD RD STE 203",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064712",
            "telephone_number": "480-292-8488",
            "fax_number": "480-292-8292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEMEH",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-15",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "7328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.