Tanner Cook, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

7572 Issued in AZ

Practice address

3540 E Baseline Rd Ste 130
Phoenix, AZ 85042-9629

Phone

(623) 251-7559

NPI assigned

Oct 30, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prisma Community CareGroup PAC ID 3678518016, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Prisma Community Care

  dba Southwest Center

  • Psychiatric/Mental Health Nurse Practitioner
  • Phoenix, AZ
  • NPI 1104929504
  Medicare reassignment Care Compare group
• Alevea Mental Health LLC

  • Physician Assistant
  • Tempe, AZ
  • NPI 1619482478
  Medicare reassignment
• Khakwani and Mohammad Medical PC

  dba PDS Medical Group Baseline

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1518672278
  Medicare reassignment
• Khakwani and Mohammad Medical PC

  dba PDS Medical Group North Mesa

  • Family Medicine Physician
  • Mesa, AZ
  • NPI 1932968369

  Physician Assistant

  NPD
• Khakwani and Mohammad Medical PC

  dba PDS Medical Group Buckeye

  • Family Medicine Physician
  • Buckeye, AZ
  • NPI 1255046918
  NPD (past)
• Privia Medical Group Arizona, LLC

  • Family Medicine Physician
  • Payson, AZ
  • NPI 1740459700
  NPD (past)
• Psychiatric Associates, PLLC

  • Child & Adolescent Psychiatry Physician
  • Tempe, AZ
  • NPI 1699681718
  NPD (past)

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

{
    "created_epoch": "1540857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1629545579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 E BELL RD STE 2200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322139",
            "telephone_number": "602-633-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3540 E BASELINE RD STE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850429629",
            "telephone_number": "623-251-7559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "TANNER",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-30",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "7572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Andrew Cook, O.D
• Sara Cook, COTA/L
• Savannah Cook, PHARMD
• Shane Cook, PA
• Stephen Michael Cook, MS, BCBA, LBA
• April Mary Cooke, MD
• Cari Leigh Cooke, OTR/L
• Jason J Cool, M.D.
• Steven A. Cool, DC
• Jean Coole, PMHNP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; 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.