Individual provider Active NPI

Sara Leah Allen, PAC

  • Medical Physician Assistant
  • Maricopa, AZ
National Provider Identifier
1427166396
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
3507 Issued in AZ
Practice address
21300 N John Wayne Pkwy Ste 115
Maricopa, AZ 85139-8978
Phone
(520) 426-3424
Fax
(520) 568-9560
NPI assigned
Aug 29, 2006
Last updated
Jan 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 3507 AZ Primary
Physician Assistant 363A00000X 1055 WI

Addresses

Primary practice location

21300 N John Wayne Pkwy Ste 115
Maricopa, AZ 85139-8978

Mailing address

3030 N Central Ave Ste 1001
Phoenix, AZ 85012-2716
Phone (602) 406-4786

Other practice location 1

6655 S Rural Rd
3
Tempe, AZ 85283-3793
Phone (480) 831-0600

Other practice location 2

2850 E Main St Ste 106
Mesa, AZ 85213-9304
Phone (480) 618-0019

Other names 1

  • Sara Leah Gilles Former name

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
I20070810000040 AZ Practitioner - Physician Assistant 1759367279 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oak Street Health Physicians Group of Arizona PLLCGroup PAC ID 3274939988, 76 clinicians

Practice addresses (Care Compare)

2850 E Main St
Suite 106
Mesa, AZ 85213-9304
Phone (480) 618-0019

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3507AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph's Hospital and Medical Center CurrentSince Aug 30, 2020 Accepting new patients

Locations

3030 N Central Ave
Ste 1001
Phoenix, AZ 85012

File 56765
Los Angeles, CA 90074

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1427166396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 N CENTRAL AVE STE 1001",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122716",
            "telephone_number": "602-406-4786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21300 N JOHN WAYNE PKWY STE 115",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851398978",
            "telephone_number": "520-426-3424",
            "fax_number": "520-568-9560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6655 S Rural Rd",
            "address_2": "3",
            "address_purpose": "LOCATION",
            "city": "Tempe",
            "state": "AZ",
            "postal_code": "852833793",
            "country_code": "US",
            "telephone_number": "480-831-0600",
            "fax_number": "480-820-3065",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2850 E Main St Ste 106",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852139304",
            "country_code": "US",
            "telephone_number": "480-618-0019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "SARA",
        "middle_name": "LEAH",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "3507",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1055",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "GILLES",
            "middle_name": "LEAH",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Maricopa, AZ

Sources for this page

Verify at the official NPI Registry.