Individual provider Active NPI

Vicky Dramaretska, PA-C

  • Physician Assistant
  • Glendale, AZ
National Provider Identifier
1437434602
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5056 Issued in AZ
Practice address
5750 W Thunderbird Rd
Suite F-640
Glendale, AZ 85306-4691
Phone
(480) 300-6065
Fax
(855) 923-0899
NPI assigned
Oct 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

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 5056 AZ Primary

Addresses

Primary practice location

5750 W Thunderbird Rd
Suite F-640
Glendale, AZ 85306-4691

Mailing address

5750 W Thunderbird Rd
Suite F-640
Glendale, AZ 85306-4691
Phone (480) 300-6065

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
I20120611000569 AZ Practitioner - Physician Assistant 4587828157

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1318982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1437434602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5750 W THUNDERBIRD RD",
            "address_2": "SUITE F-640",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064691",
            "telephone_number": "480-300-6065",
            "fax_number": "855-923-0899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 W THUNDERBIRD RD",
            "address_2": "SUITE F-640",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064691",
            "telephone_number": "480-300-6065",
            "fax_number": "855-923-0899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAMARETSKA",
        "first_name": "VICKY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-19",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "5056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.