Laurie Giacoletto, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5413 Issued in AZ

Practice address

407 N Lindsay Rd Ste 103-104
Mesa, AZ 85213-7710

Phone

(480) 807-0084

Fax

(480) 807-0091

NPI assigned

Dec 15, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in SD

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

Specialty

Physician Assistant

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Black Hills Surgical Hospital LLCGroup PAC ID 5496742835, 173 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Black Hills Surgical Hospital LLC Hospital, Rapid City, SD, CCN 430091

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Black Hills Surgical Hospital, LLC

  • Urgent Care Clinic/Center
  • Rapid City, SD
  • NPI 1336009646
  Medicare reassignment Care Compare group
• Monument Health Rapid City Hospital, Inc

  • Multi-Specialty Clinic/Center
  • Rapid City, SD
  • NPI 1275553463
  Medicare reassignment
• Black Hills Surgical Hospital, LLC

  • Urgent Care Clinic/Center
  • Rapid City, SD
  • NPI 1124385554
  NPD
• Black Hills Surgical Hospital, LLC

  • Special Hospital
  • Rapid City, SD
  • NPI 1376896621
  NPD
• Black Hills Surgical Hospital, LLC

  • Anesthesiology Physician
  • Rapid City, SD
  • NPI 1972630275
  NPD
• Monument Health Rapid City Hospital Inc

  • Urgent Care Clinic/Center
  • Rapid City, SD
  • NPI 1215727854
  NPD
• Monument Health Rapid City Hospital Inc

  • Clinic/Center
  • Rapid City, SD
  • NPI 1437860954
  NPD
• East Valley Urgent Care, LLC

  • Urgent Care Clinic/Center
  • San Tan Valley, AZ
  • NPI 1649515347
  NPD (past)
• East Valley Urgent Care,LLC

  • Urgent Care Clinic/Center
  • Tempe, AZ
  • NPI 1710222419
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Black Hills Surgical Hospital, LLC

  • Special Hospital
  • Rapid City, SD
  • NPI 1679535132
  Care Compare affiliation

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429142400000",
    "number": "1477539138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 S CLEARVIEW AVE STE 100",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093378",
            "telephone_number": "480-988-9108",
            "fax_number": "480-813-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 N LINDSAY RD STE 103-104",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852137710",
            "telephone_number": "480-807-0084",
            "fax_number": "480-807-0091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIACOLETTO",
        "first_name": "LAURIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-15",
        "last_updated": "2015-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9289",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "5413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "Z162194",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "859739",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kojasteh Mahsa Ghaziaskar, MD
• GHGB-I PLLC
• Deslie Annette Ghiorzi I
• Natasha Ghofrani
• Ria Ghose Kundu, M.D.
• Andrew Carl Arland Gibbons III, M.S.
• Laci Gibbons
• Mary E Gibbons, M.M.E.
• Gibraltar Psychiatric Services, Inc
• Carla Gibson

• Physician Assistant in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.