Individual provider Active NPI

Sandra-Lynn Frances Hutchison, P.A.

  • Physician Assistant
  • Prescott, AZ
National Provider Identifier
1497761332
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2716 Issued in AZ
Practice address
830 Ainsworth Dr
Prescott, AZ 86301-1630
Phone
(928) 777-5800
Fax
(928) 776-0405
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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 2716 AZ Primary

Addresses

Primary practice location

830 Ainsworth Dr
Prescott, AZ 86301-1630

Mailing address

801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9008

Other identifiers 1

IdentifierTypeStateIssuer
120430MedicaidAZ

Other names 1

  • Sandra-Lynn Frances Piette 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
I20060921000076 AZ Practitioner - Physician Assistant 2860482056

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.45 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Associates in Dermatology and Cosmetic Surgery, LLC CurrentSince Nov 22, 2014 Accepting new patients

Locations

2035 Mesquite Ave
Lk Havasu Cty, AZ 86403
Phone (928) 208-4598

830 Ainsworth Dr
Prescott, AZ 86301
Phone (928) 202-4143

2820 N Glassford Hill Rd
Ste 107
Prescott Vly, AZ 86314
Phone (928) 772-8553

Interoperability endpoints

  • Direct secure messaging: sandra.hutchison@forefrontdermatology.emadirect.md

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.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1497761332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 AINSWORTH DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011630",
            "telephone_number": "928-777-5800",
            "fax_number": "928-776-0405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTCHISON",
        "first_name": "SANDRA-LYNN",
        "middle_name": "FRANCES",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "2716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120430",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA-LYNN",
            "last_name": "PIETTE",
            "middle_name": "FRANCES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.