Individual provider Active NPI

Heather Renee Venema, PA-C

  • Medical Physician Assistant
  • Peoria, AZ
National Provider Identifier
1457584823
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
4516 Issued in AZ
Practice address
13943 N 91St Ave Ste 101
Peoria, AZ 85381-3629
Phone
(623) 254-7271
Fax
(888) 388-1953
NPI assigned
Sep 1, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 4516 AZ Primary

Addresses

Primary practice location

13943 N 91St Ave Ste 101
Peoria, AZ 85381-3629

Mailing address

13460 N 94TH Dr Ste J1
Peoria, AZ 85381-4246
Phone (623) 876-8816

Other identifiers 1

IdentifierTypeStateIssuer
163954MedicaidAZ

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
I20091110000608 AZ Practitioner - Physician Assistant 7911045018 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sage Hematology and Oncology PLCGroup PAC ID 7719342799, 2 clinicians
Ironwood Physicians PCGroup PAC ID 3577454842, 115 clinicians

Practice addresses (Care Compare)

13943 N 91St Ave
Suite 101
Peoria, AZ 85381-3629
Phone (623) 254-7271

14815 W Bell Rd
Suite 106
Surprise, AZ 85374-7603
Phone (623) 312-3012

Hospital & facility affiliations

  • Wickenburg Community Hospital Hospital, Wickenburg, AZ, CCN 031300
  • Banner del E. Webb Medical Center Hospital, Sun City West, AZ, CCN 030093
  • Banner Boswell Medical Center Hospital, Sun City, AZ, CCN 030061

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4516AZMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ironwood Physicians, PC CurrentSince Dec 1, 2025 Accepting new patients
Ironwood Physicians, PC CurrentSince Dec 1, 2025 Accepting new patients
Banner Cancer Center Specialists LLC CurrentSince Oct 1, 2022 Accepting new patients
Navjeet K Gandhok MD PLLC PastSince Dec 1, 2021 Accepting new patients

Locations

2946 E Banner Gateway Dr
Gilbert, AZ 85234
Phone (480) 256-5450

5810 W Beverly Ln
Glendale, AZ 85306
Phone (623) 312-3000

1710 N 159th Ave
Goodyear, AZ 85395
Phone (623) 312-3020

6111 E Arbor Ave
Mesa, AZ 85206
Phone (480) 981-1326

13041 N Del Webb Blvd
Ste 200
Sun City, AZ 85351
Phone (623) 832-0300

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

14815 W Bell Rd
Ste 106
Surprise, AZ 85374
Phone (623) 312-3000

Interoperability endpoints

  • Direct secure messaging: heather.venema@sagehemonc.ikm.direct-ci.com

Organizations & group practices 7

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 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": "1251763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1457584823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13460 N 94TH DR STE J1",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814246",
            "telephone_number": "623-876-8816",
            "fax_number": "623-298-0168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13943 N 91ST AVE STE 101",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853813629",
            "telephone_number": "623-254-7271",
            "fax_number": "888-388-1953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENEMA",
        "first_name": "HEATHER",
        "middle_name": "RENEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-01",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "4516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "163954",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.