Alicia K Laduke, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3130 Issued in AZ

Practice address

165 W 7TH St S
Snowflake, AZ 85937-5507

Phone

(480) 216-8621

NPI assigned

May 27, 2006

Last updated

Jun 25, 2025By the provider in NPPES

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 names 1

• Alicia K Brimhall Former name

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

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Donsky Bogle Dermatology LLCGroup PAC ID 6608930763, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Donsky Bogle Dermatology LLC

  dba Grand Canyon Dermatology PLLC

  • Dermatology Physician
  • Mesa, AZ
  • NPI 1982849691
  Medicare reassignment Care Compare group
• Clin-Path Pathology

  • Anatomic Pathology & Clinical Pathology Physician
  • Phoenix, AZ
  • NPI 1922079706
  NPD (past)

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1619924487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 W 7TH ST S",
            "city": "SNOWFLAKE",
            "state": "AZ",
            "postal_code": "859375507",
            "telephone_number": "480-216-8621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 W 7TH ST S",
            "city": "SNOWFLAKE",
            "state": "AZ",
            "postal_code": "859375507",
            "telephone_number": "480-216-8621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADUKE",
        "first_name": "ALICIA",
        "middle_name": "K",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-27",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "3130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "BRIMHALL",
            "middle_name": "K",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Bryce Jones, DMD
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• Mark Lindsay, FNP-BC, PMHNP-BC
• Michael Shane Luck, LPC

• Physician Assistant in Snowflake, AZ
• Providers in Snowflake, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2025; 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.
• 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.