NPIMap

Individual provider Active NPI

Danielle Moller, PA-C

  • Surgical Physician Assistant
  • Goodyear, AZ
National Provider Identifier
1447566302
Registry record updated Feb 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
5393 Issued in AZ
Practice address
13555 W McDowell Rd
#302
Goodyear, AZ 85395-2624
Phone
(623) 512-4390
Fax
(623) 512-4391
NPI assigned
Aug 29, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2016

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 21146 CA
Surgical Physician Assistant 363AS0400X 5393 AZ Primary

Addresses

Primary practice location

13555 W McDowell Rd
#302
Goodyear, AZ 85395-2624

Mailing address

13555 W McDowell Rd
#302
Goodyear, AZ 85395-2624
Phone (623) 512-4390

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
I20160226001033 AZ Practitioner - Physician Assistant 8820393960 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arizona Urology LLCGroup PAC ID 9537566930, 11 clinicians

Practice addresses (Care Compare)

3815 E Bell Rd
Suite 4200
Phoenix, AZ 85032-2168
Phone (623) 512-4390

Hospital & facility affiliations

  • Banner Thunderbird Medical Center Hospital, Glendale, AZ, CCN 030089
  • Abrazo West Campus Hospital, Goodyear, AZ, CCN 030110
  • St Josephs Hospital and Medical Center Hospital, Phoenix, AZ, CCN 030024
  • Banner Estrella Medical Center Hospital, Phoenix, AZ, CCN 030115

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5393AZMDGeneral Practice Dentistry
21146CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Yavapai Regional Medical Center Physician Care LLC CurrentSince Apr 14, 2023 Accepting new patients
Palo Verde Hematology Oncology LTD. CurrentSince Jan 1, 2017 Accepting new patients
Privia Medical Group Arizona, LLC Past Accepting new patients

Locations

1488 W Elliot Rd
Gilbert, AZ 85233

17560 N 75th Ave
Ste 440
Glendale, AZ 85308
Phone (619) 985-6464

13555 W McDowell Rd
Ste 201
Goodyear, AZ 85395
Phone (602) 246-9006

13555 W McDowell Rd
Ste 302
Goodyear, AZ 85395

10238 E Hampton Ave
Ste 202
Mesa, AZ 85209
Phone (480) 399-2002

3815 E Bell Rd
Ste 4500
Phoenix, AZ 85032
Phone (602) 633-3838

9250 W Thomas Rd
Ste 150
Phoenix, AZ 85037
Phone (623) 478-8091

3120 Clearwater Dr
Prescott, AZ 86305
Phone (928) 445-4818

Interoperability endpoints

  • Direct secure messaging: danielle.moller.1@15230.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 7

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": "1283040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456099200000",
    "number": "1447566302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13555 W MCDOWELL RD",
            "address_2": "#302",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952624",
            "telephone_number": "623-512-4390",
            "fax_number": "623-512-4391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13555 W MCDOWELL RD",
            "address_2": "#302",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952624",
            "telephone_number": "623-512-4390",
            "fax_number": "623-512-4391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLLER",
        "first_name": "DANIELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-29",
        "last_updated": "2016-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "21146",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "5393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

Verify at the official NPI Registry.