Jessica Ta, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10924 Issued in AZ

Practice address

1120 S Dobson Rd Ste 115
Chandler, AZ 85286-6166

Phone

(602) 843-2991

NPI assigned

Jul 12, 2022

Last updated

Mar 3, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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

At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Arizona Asthma Allergy Legacy PLCGroup PAC ID 3072909290, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.60978

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.

• Arizona Asthma Allergy Legacy PLC

  • Allergy & Immunology Physician
  • Peoria, AZ
  • NPI 1922762699
  Medicare reassignment Care Compare group
• Arizona Asthma & Allergy Institute LTD

  • Allergy & Immunology Physician
  • Peoria, AZ
  • NPI 1922099498

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1657584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1679207914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 N 3RD AVE UNIT 1216",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850031784",
            "telephone_number": "954-940-1285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 S DOBSON RD STE 115",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852866166",
            "telephone_number": "602-843-2991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13965 N 75th Ave",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "AZ",
            "postal_code": "853816097",
            "country_code": "US",
            "telephone_number": "602-843-2991",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15331 W. Bell Rd",
            "address_2": "Ste. 308/310",
            "address_purpose": "LOCATION",
            "city": "Surprise",
            "state": "AZ",
            "postal_code": "85374",
            "country_code": "US",
            "telephone_number": "602-843-2991",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13860 N Northsight Blvd",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852603654",
            "country_code": "US",
            "telephone_number": "602-843-2991",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3200 E Camelback Rd Ste 125",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850182325",
            "country_code": "US",
            "telephone_number": "602-843-2991",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13026 W Rancho Santa Fe Blvd Ste A100",
            "address_purpose": "LOCATION",
            "city": "Avondale",
            "state": "AZ",
            "postal_code": "853921704",
            "country_code": "US",
            "telephone_number": "602-843-2991",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4140 E Baseline Rd Ste 112",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852064413",
            "country_code": "US",
            "telephone_number": "602-843-2991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TA",
        "first_name": "JESSICA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-12",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": "AZ",
            "license": "10924",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "10924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.