NPIMap

Individual provider Active NPI

Crystal Marie Heiligenthal, PA

  • Medical Physician Assistant
  • Glendale, AZ
National Provider Identifier
1487805628
Registry record updated Oct 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
4296 Issued in AZ
Practice address
6320B W Union Hills Dr
Ste B2300
Glendale, AZ 85308-1376
Phone
(623) 561-9113
Fax
(623) 561-6148
NPI assigned
Oct 7, 2008
Last updated
Oct 3, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2013

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 4296 AZ Primary

Addresses

Primary practice location

6320B W Union Hills Dr
Ste B2300
Glendale, AZ 85308-1376

Mailing address

2500 W Utopia Rd
Ste. 100
Phoenix, AZ 85027-4171
Phone (623) 434-6200

Other identifiers 1

IdentifierTypeStateIssuer
4296OtherAZLICENSE

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
I20081231000469 AZ Practitioner - Physician Assistant 0547322430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Honorhealth Medical Group, LLCGroup PAC ID 1557274057, 338 clinicians

Practice addresses (Care Compare)

10230 W Happy Valley Pkwy
Suite 100
Peoria, AZ 85383-4692
Phone (623) 266-4699

15000 N 83Rd Ave
Unit 200
Peoria, AZ 85381-2002
Phone (623) 849-3811

19636 N 27TH Ave
Suite 308
Phoenix, AZ 85027-4020
Phone (623) 780-1999

3648 W Anthem Way
Suite A100
Anthem, AZ 85086-7002
Phone (623) 238-7310

6220 W Bell Rd
Glendale, AZ 85308-3896

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Honorhealth Medical Group, LLC CurrentSince Jan 8, 2012 Accepting new patients
Honorhealth Medical Group, LLC CurrentSince Jan 8, 2012 Accepting new patients
Honorhealth Medical Group, LLC Past Accepting new patients
Honorhealth Medical Group, LLC Past Accepting new patients
Honorhealth Urgent Care, LLC Past Accepting new patients
Honorhealth Urgent Care, LLC Past Accepting new patients
Honorhealth Urgent Care, LLC Past Accepting new patients
Honorhealth Medical Group, LLC Past Accepting new patients

Locations

3648 W Anthem Way
Ste A100
Anthem, AZ 85086
Phone (623) 434-6444

6220 W Bell Rd
Ste 130
Glendale, AZ 85308
Phone (602) 547-7348

6320 W Union Hills Dr
Ste 2300B
Glendale, AZ 85308
Phone (623) 561-9113

10230 W Happy Valley Pkwy
Ste 100C
Peoria, AZ 85383
Phone (623) 561-3030

1515 E Bethany Home Rd
Ste 120B
Phoenix, AZ 85014
Phone (602) 547-7335

2500 W Utopia Rd
Ste 100
Phoenix, AZ 85027
Phone (623) 683-4462

Interoperability endpoints

  • Direct secure messaging: cheiligenthal8231@direct.honorhealth.com

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1223337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380758400000",
    "number": "1487805628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W UTOPIA RD",
            "address_2": "STE. 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274171",
            "telephone_number": "623-434-6200",
            "fax_number": "623-434-6164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6320B W UNION HILLS DR",
            "address_2": "STE B2300",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081376",
            "telephone_number": "623-561-9113",
            "fax_number": "623-561-6148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEILIGENTHAL",
        "first_name": "CRYSTAL",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-07",
        "last_updated": "2013-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "4296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "4296",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.