Individual provider Active NPI

Chase Meilleur, PA-C

  • Surgical Physician Assistant
  • Scottsdale, AZ
National Provider Identifier
1447987250
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
10414 Issued in AZ
Practice address
9735 N 90TH PL
Scottsdale, AZ 85258-5067
Phone
(480) 222-4954
Fax
(480) 210-5460
NPI assigned
Aug 2, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 10414 AZ Primary

Addresses

Primary practice location

9735 N 90TH PL
Scottsdale, AZ 85258-5067

Mailing address

9735 N 90TH PL
Scottsdale, AZ 85258-5067

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
I20240920000161 AZ Practitioner - Physician Assistant 1355882168 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spine Institute of Arizona PCGroup PAC ID 8921090184, 11 clinicians

Practice addresses (Care Compare)

9735 N 90TH PL
Scottsdale, AZ 85258-5067
Phone (602) 953-9500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10414AZMDSpeech-Language Assistant

Organizations & group practices 1

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 2

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": "1659398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1447987250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9735 N 90TH PL",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852585067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9735 N 90TH PL",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852585067",
            "telephone_number": "480-222-4954",
            "fax_number": "480-210-5460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEILLEUR",
        "first_name": "CHASE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-02",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "10414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.