Northern Arizona Surgical Assisting LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

NORTHERN ARIZONA SURGICAL ASSISTING LLC

Practice address

4209 W Indigo Way
Flagstaff, AZ 86001-8228

Phone

(760) 731-0313

Fax

(951) 587-8277

NPI assigned

Jun 5, 2020

Last updated

Apr 16, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jessica A Diefenbach, NPNPI 1861016735

Title

Owner

Phone

(214) 227-2457

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Flagstaff Bone & Joint Surgical Center, LLC

  dba Surgery Center at Flagstaff Bone & Joint

  • Ambulatory Surgical Clinic/Center
  • Flagstaff, AZ
  • NPI 1689222317

  O20231122001514

  Same enrollment

Locations

Practitioners 1

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.

• Jessica A Diefenbach, NP

  • Nurse Practitioner
  • Sparks, NV
  • NPI 1861016735

  AZ, Registered Nurse First Assistant

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1591315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744761600000",
    "number": "1568086437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4209 W INDIGO WAY",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860018228",
            "telephone_number": "214-227-2457",
            "fax_number": "214-764-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4209 W INDIGO WAY",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860018228",
            "telephone_number": "760-731-0313",
            "fax_number": "951-587-8277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN ARIZONA SURGICAL ASSISTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-05",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A",
        "authorized_official_last_name": "DIEFENBACH",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-227-2457",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northern Arizona Senior Living Community, L.L.C. (The Peaks Health & Rehabilitation)
• Northern Arizona Speech-Language Service Providers, PLLC (Northern Arizona Speech/Language Service Providers)
• Northern Arizona Spinal Care, PLLC
• Northern Arizona Substance Abuse Services
• Northern Arizona Surgical
• Northern Arizona Surgicenter, LLC
• Northern Arizona University
• Northern Arizona University (AZ Board of Regents on Behalf of Northern Arizona University)
• Northern Arizona University
• Northern Arizona Urology

• Nurse Practitioner in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.