NPIMap

Individual provider Active NPI

Micole Neely, MD, PA-C

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1437344264
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3679 Issued in AZ
Practice address
702 W Camelback Rd Ste 20
Phoenix, AZ 85013-2291
Phone
(602) 845-5950
NPI assigned
Sep 14, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2025

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 3679 AZ Primary

Addresses

Primary practice location

702 W Camelback Rd Ste 20
Phoenix, AZ 85013-2291

Mailing address

PO Box 65223
Phoenix, AZ 85082-5223
Phone (602) 689-2349

Other identifiers 2

IdentifierTypeStateIssuer
409214MedicaidAZ
3679OtherAZAZ LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090227000232 AZ Practitioner - Physician Assistant 4981760931 Reassigns benefits to 8 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine, Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Med 97 LLC Past Accepting new patients
Center for Physical Medicine & Rehabilitation P C Past Accepting new patients
Accessmd Plus LLC Past Accepting new patients
Empower Emergency Physicians, PC Past Accepting new patients
Arizona Heart Specialists PLLC Past Accepting new patients

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1189728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746748800000",
    "number": "1437344264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 65223",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850825223",
            "telephone_number": "602-689-2349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 W CAMELBACK RD STE 20",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850132291",
            "telephone_number": "602-845-5950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEELY",
        "first_name": "MICOLE",
        "credential": "MD, PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-14",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "3679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "409214",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ LICENSE",
            "identifier": "3679",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.