Individual provider Active NPI

Alaina Anne Vacco, PA-C

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1538400692
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5323 Issued in AZ
Practice address
7600 N 15TH St Ste 100
Phoenix, AZ 85020-4330
Phone
(602) 704-2345
Fax
(602) 704-2399
NPI assigned
Mar 13, 2013
Last updated
Mar 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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 5323 AZ Primary

Addresses

Primary practice location

7600 N 15TH St Ste 100
Phoenix, AZ 85020-4330

Mailing address

1 N 1St St FL 7
Phoenix, AZ 85004-2357
Phone (602) 704-2345

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
I20130606000837 AZ Practitioner - Physician Assistant 7315185014 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mental Health Center of America, LLCGroup PAC ID 7012308257, 9 clinicians

Practice addresses (Care Compare)

7600 N 15TH St
Suite 100
Phoenix, AZ 85020-4330
Phone (602) 704-2345

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5323AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
VHS Outpatient Clinics, Inc. CurrentSince Apr 11, 2016 Accepting new patients
Privia Medical Group Arizona, LLC Past Accepting new patients

Locations

5130 W Baseline Rd
Ste 102
Laveen, AZ 85339
Phone (602) 237-0039

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1363132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1538400692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 N 1ST ST FL 7",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850042357",
            "telephone_number": "602-704-2345",
            "fax_number": "602-704-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 N 15TH ST STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204330",
            "telephone_number": "602-704-2345",
            "fax_number": "602-704-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACCO",
        "first_name": "ALAINA",
        "middle_name": "ANNE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-13",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "5323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.