NPIMap

Individual provider Active NPI

Sara Lynne Hartman, PA-C

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1629247796
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3791 Issued in AZ
Practice address
4045 E Bell Rd Ste 125
Phoenix, AZ 85032-2238
Phone
(602) 971-0268
Fax
(602) 971-1556
NPI assigned
Feb 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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 3791 AZ Primary

Addresses

Primary practice location

4045 E Bell Rd Ste 125
Phoenix, AZ 85032-2238

Mailing address

4045 E Bell Rd Ste 125
Phoenix, AZ 85032-2238
Phone (602) 971-0268

Other practice location 1

715 S Beeline Hwy
Payson, AZ 85541-5320
Phone (928) 468-6607

Other practice location 2

313 S Beeline Hwy
Payson, AZ 85541-4814
Phone (928) 472-7107

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080318000418 AZ Practitioner - Physician Assistant 4789760695 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alliance Dermatology and Mohs Center PCGroup PAC ID 7113144510, 10 clinicians

Practice addresses (Care Compare)

4045 E Bell Rd
Suite 125
Phoenix, AZ 85032-2238
Phone 6029710268205

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3791AZMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gold Star Medical LLC Past Accepting new patients
Tri-City Express Care, PLLC Past Accepting new patients
Tri-City Express Care, PLLC Past Accepting new patients
Tri-City Express Care, PLLC Past Accepting new patients
Tri-City Express Care, PLLC Past Accepting new patients
Center for Physical Medicine & Rehabilitation P C Past Accepting new patients
Desert Valley Radiology, PLC Past Accepting new patients
Tri-City Express Care, PLLC Past Accepting new patients
Med 97 LLC Past Accepting new patients
Mark a Meyers Past Accepting new patients
Honorhealth Urgent Care, LLC Past Accepting new patients
Tri-City Express Care, PLLC Past Accepting new patients
19TH Avenue Clinic LLC Past Accepting new patients
Richard Lee Averitte Jr PLLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sarah@alliancederm.emadirect.md
  • Direct secure messaging: sarahartman@ad.allscriptsdirect.net

Organizations & group practices 15

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1203638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1629247796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 E BELL RD STE 125",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322238",
            "telephone_number": "602-971-0268",
            "fax_number": "602-971-1556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 E BELL RD STE 125",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322238",
            "telephone_number": "602-971-0268",
            "fax_number": "602-971-1556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "715 S Beeline Hwy",
            "address_purpose": "LOCATION",
            "city": "Payson",
            "state": "AZ",
            "postal_code": "855415320",
            "country_code": "US",
            "telephone_number": "928-468-6607",
            "fax_number": "928-468-6658",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "313 S Beeline Hwy",
            "address_purpose": "LOCATION",
            "city": "Payson",
            "state": "AZ",
            "postal_code": "855414814",
            "country_code": "US",
            "telephone_number": "928-472-7107",
            "fax_number": "928-472-6025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARTMAN",
        "first_name": "SARA",
        "middle_name": "LYNNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-22",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "3791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.