Individual provider Active NPI

Brittny Rae Neis, PA-C

  • Physician Assistant
  • Sun City, AZ
National Provider Identifier
1619466679
Registry record updated Jun 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7087 Issued in AZ
Practice address
13640 N 99TH Ave Ste 600
Sun City, AZ 85351-2867
Phone
(623) 972-2116
NPI assigned
May 5, 2018
Last updated
Jun 8, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2018

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 7087 AZ Primary

Addresses

Primary practice location

13640 N 99TH Ave Ste 600
Sun City, AZ 85351-2867

Mailing address

3020 E Camelback Rd
Ste 301
Phoenix, AZ 85016-4418
Phone (602) 264-9100

Other practice location 1

14869 W Bell Rd Ste 100
Surprise, AZ 85374-7608
Phone (623) 972-2116

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180626001930 AZ Practitioner - Physician Assistant 4688929029 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7087AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Az Care Anesthesia , PLC PastSince Jun 1, 2014 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: brittny.neispac.p1@direct.nextcare.nextgenshare.com

Organizations & group practices 3

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": "1525478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528416000000",
    "number": "1619466679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 E CAMELBACK RD",
            "address_2": "STE 301",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164418",
            "telephone_number": "602-264-9100",
            "fax_number": "602-264-9101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13640 N 99TH AVE STE 600",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853512867",
            "telephone_number": "623-972-2116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14869 W Bell Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Surprise",
            "state": "AZ",
            "postal_code": "853747608",
            "country_code": "US",
            "telephone_number": "623-972-2116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEIS",
        "first_name": "BRITTNY",
        "middle_name": "RAE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-05",
        "last_updated": "2018-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "7087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City, AZ

Sources for this page

Verify at the official NPI Registry.