NPIMap

Organization Active NPI

Prasada Health Center LLC

  • General Practice Physician
  • Surprise, AZ
National Provider Identifier
1508532458
Registry record updated Aug 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
PRASADA HEALTH CENTER LLC
Practice address
13733 N. Prasada Parkway, Suite 100
Surprise, AZ 85388
Phone
(480) 497-4506
NPI assigned
Aug 20, 2021
Last updated
Aug 20, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2021

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

Authorized official

Name
Greg VogelNPI 1235183138
Title
Ceo
Phone
(480) 497-2900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Chiropractor 111N00000X NU
Physical Medicine & Rehabilitation Physician 208100000X NU
General Practice Physician 208D00000X NU Primary
Physical Therapist 225100000X NU

Addresses

Primary practice location

13733 N. Prasada Parkway, Suite 100
Surprise, AZ 85388

Mailing address

754 S Val Vista Dr Ste 105
Gilbert, AZ 85296-3139

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220125000356 AZ Part B Supplier - Clinic/Group Practice 8628460672 Receives reassigned benefits from 11 practitioners
Practice locations: Surprise, AZ
O20220726001900 AZ DME Supplier - Medical Supply Company With Orthotic Personnel 8628460672 Practice locations: Surprise, AZ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Prasada Health Center, LLC13733 N Prasada Pkwy, Surprise, AZ 85388-8014(623) 444-7100 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf Accepts assignmentParticipating since Oct 15, 2021

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1629417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629417600000",
    "number": "1508532458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "754 S VAL VISTA DR STE 105",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852963139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13733 N. PRASADA PARKWAY, SUITE 100",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "85388",
            "telephone_number": "480-497-4506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRASADA HEALTH CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-20",
        "last_updated": "2021-08-20",
        "certification_date": "2021-07-29",
        "status": "A",
        "authorized_official_last_name": "VOGEL",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "480-497-2900"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.