Individual provider Active NPI

Luminita Iacob, PA

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1477535433
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3017 Issued in AZ
Practice address
4550 N 51St Ave
Suite 7
Phoenix, AZ 85031-1708
Phone
(623) 846-7597
Fax
(623) 846-1826
NPI assigned
Nov 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 3017 AZ Primary

Addresses

Primary practice location

4550 N 51St Ave
Suite 7
Phoenix, AZ 85031-1708

Mailing address

4550 N 51St Ave
Suite 7
Phoenix, AZ 85031-1708
Phone (623) 846-7597

Other names 1

  • Luminita Gherghelas Former name

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
I20040903001086 AZ Practitioner - Physician Assistant 0941276513 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
M.L.Erickson, M.D.,L.L.C.Group PAC ID 3577554377, 2 clinicians

Practice addresses (Care Compare)

6370 W Union Hills Dr
Glendale, AZ 85308-7136
Phone (623) 414-3500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3017AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Oncology & Hematology, PC Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1477535433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 N 51ST AVE",
            "address_2": "SUITE 7",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850311708",
            "telephone_number": "623-846-7597",
            "fax_number": "623-846-1826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 N 51ST AVE",
            "address_2": "SUITE 7",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850311708",
            "telephone_number": "623-846-7597",
            "fax_number": "623-846-1826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IACOB",
        "first_name": "LUMINITA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-16",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "3017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LUMINITA",
            "last_name": "GHERGHELAS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.