Individual provider Active NPI

Lauren Elizabeth McWilliams, PA-C

  • Physician Assistant
  • Mesa, AZ
National Provider Identifier
1417848953
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11213 Issued in AZ
Practice address
4135 S Power Rd Ste 113
Mesa, AZ 85212-3625
Phone
(480) 626-2444
Fax
(480) 409-2987
NPI assigned
Jul 12, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 11213 AZ
Medical Physician Assistant 363AM0700X 11213 AZ
Physician Assistant 363A00000X 11213 AZ Primary

Addresses

Primary practice location

4135 S Power Rd Ste 113
Mesa, AZ 85212-3625

Mailing address

PO Box 88747
Milwaukee, WI 53288-8747
Phone (480) 945-6777

Other practice location 1

4455 E Camelback Rd Ste D155
Phoenix, AZ 85018-2888
Phone (480) 626-2444

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
I20250821004110 AZ Practitioner - Physician Assistant 9234639584 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Forte - Phoenix PLLCGroup PAC ID 7618240797, 11 clinicians

Practice addresses (Care Compare)

4135 S Power Rd
Suite 113
Mesa, AZ 85212-3625
Phone (480) 626-2444

4455 E Camelback Rd
Suite D155
Phoenix, AZ 85018-2888
Phone (480) 626-2444

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11213AZMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Camelback Sports Therapy LLC PastSince Nov 1, 2015 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1752278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1417848953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 88747",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532888747",
            "telephone_number": "480-945-6777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4135 S POWER RD STE 113",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852123625",
            "telephone_number": "480-626-2444",
            "fax_number": "480-409-2987"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4455 E Camelback Rd Ste D155",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850182888",
            "country_code": "US",
            "telephone_number": "480-626-2444",
            "fax_number": "833-473-4947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCWILLIAMS",
        "first_name": "LAUREN",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-12",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "11213",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "11213",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "11213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.