Carrie Jacovini, PA C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2312 Issued in AZ

Practice address

18589 N 59TH Ave
Ste 101
Glendale, AZ 85308

Phone

(480) 776-1588

Fax

(602) 547-8700

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Carrie Haas Former name

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CFADBA

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.

• Emergency Care Services of Pennsylvania, P.C.

  • Emergency Medicine Physician
  • Langhorne, PA
  • NPI 1114955010

  PA

  Medicare reassignment
• Monarch Medical, LLC

  • Urgent Care Clinic/Center
  • Phoenixville, PA
  • NPI 1801206305

  PA

  Medicare reassignment
• Prospect Health Access Network, Inc.

  • Emergency Medicine Physician
  • Chester, PA
  • NPI 1568819084

  PA

  Medicare reassignment
• Radnor Family Practice Professional Limited Liability Company

  • Family Medicine Physician
  • Wayne, PA
  • NPI 1750407144

  PA

  Medicare reassignment
• Emergency Care Services of Pennsylvania, P.C.

  • Emergency Medicine Physician
  • Wilkes Barre, PA
  • NPI 1235374927

  Physician Assistant

  NPD
• Monarch Integrative Medicine, LLC

  • Medical Specialty Clinic/Center
  • Phoenixville, PA
  • NPI 1356795694
  NPD
• Prospect Health Access Network, Inc.

  • Neurology Physician
  • Chester, PA
  • NPI 1013364520
  NPD
• Prospect Health Access Network, Inc.

  • Diagnostic Radiology Physician
  • Chester, PA
  • NPI 1154776797
  NPD
• Radnor Family Practice, PLLC, Dba Im Health

  • Physical Therapist
  • Wayne, PA
  • NPI 1003575788
  NPD
• Apache Junction Urgent Care LLC

  • Urgent Care Clinic/Center
  • Apache Junction, AZ
  • NPI 1053375659
  NPD (past)
• Avondale Urgent Care LLC

  • Urgent Care Clinic/Center
  • Avondale, AZ
  • NPI 1134185671
  NPD (past)
• Casa Grande Urgent Care LLC

  • Urgent Care Clinic/Center
  • Casa Grande, AZ
  • NPI 1265496863
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497867683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7194 W MOHAWK LANE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85308",
            "telephone_number": "623-376-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18589 N 59TH AVE",
            "address_2": "STE 101",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85308",
            "telephone_number": "480-776-1588",
            "fax_number": "602-547-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOVINI",
        "first_name": "CARRIE",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "2312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "748600",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARRIE",
            "last_name": "HAAS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rachel Thomas Jacob, NP-C
• Vivian Jacobo
• Don Jacobs
• Marissa Jacobs, D.O.
• Tiana Jacobson
• Jacqueline M Solomon D O P C
• Cynthia Jean Jacquemart, MD
• Amanda R. Jade, PHARMD, RPH
• David F Jaffe, DPM
• Mark Lawrence Jaffe, O.D.

• All providers in Glendale, AZ
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.