Individual provider Active NPI

Zachary Daniel Sheridan

  • Physician Assistant
  • Peoria, AZ
National Provider Identifier
1639910904
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11377 Issued in AZ
Practice address
6760 W Thunderbird Rd Ste E110
Peoria, AZ 85381-5027
Phone
(602) 648-5444
Fax
(602) 772-3801
NPI assigned
Jun 3, 2024
Last updated
Oct 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 11377 AZ Primary
Surgical Physician Assistant 363AS0400X 11377 AZ

Addresses

Primary practice location

6760 W Thunderbird Rd Ste E110
Peoria, AZ 85381-5027

Mailing address

PO Box 80217
Phoenix, AZ 85060-0217
Phone (602) 385-2115

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20251114001411 AZ Practitioner - Physician Assistant 9638660939 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BHSM Rehabilitation LLCGroup PAC ID 2062773138, shared by 27 NPIs, 450 clinicians

Practice addresses (Care Compare)

25101 N Lake Pleasant Pkwy
Suite B 1340
Peoria, AZ 85383-1386
Phone (602) 610-6866

6760 W Thunderbird Rd
Suite E110
Peoria, AZ 85381-5027
Phone (623) 846-7614

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11377AZMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Specialists of North America, PLLC CurrentSince Oct 27, 2025 Accepting new patients
Orthopedic Specialists of North America, PLLC Current Accepting new patients
Orthopedic Specialists of North America, PLLC CurrentSince Oct 27, 2025 Accepting new patients

Locations

10450 W McDowell Rd
Ste 102
Avondale, AZ 85392
Phone (623) 846-1746

14044 W Camelback Rd
Ste 120
Litchfield Park, AZ 85340
Phone (623) 846-7614

40601 N Gantzel Rd
Ste 103
San Tan Vly, AZ 85140

5620 E Bell Rd
Scottsdale, AZ 85254
Phone (602) 485-3050

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1639910904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80217",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850600217",
            "telephone_number": "602-385-2115",
            "fax_number": "480-418-3323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6760 W THUNDERBIRD RD STE E110",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815027",
            "telephone_number": "602-648-5444",
            "fax_number": "602-772-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERIDAN",
        "first_name": "ZACHARY",
        "middle_name": "DANIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-03",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "11377",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "11377",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.