Individual provider Active NPI

Benjamin Mitchell Smith, PA-C

  • Physician Assistant
  • Sun City, AZ
National Provider Identifier
1679259980
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9760 Issued in AZ
Practice address
10401 W Thunderbird Blvd
Sun City, AZ 85351-3004
Phone
(623) 832-5366
Fax
(623) 832-7520
NPI assigned
Jun 22, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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
Physician Assistant 363A00000X 9760 AZ Primary

Addresses

Primary practice location

10401 W Thunderbird Blvd
Sun City, AZ 85351-3004

Mailing address

20000 N 57TH Ave RM G205
Glendale, AZ 85308-6872
Phone (845) 249-8069

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
I20230907002506 AZ Practitioner - Physician Assistant 7113381203 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tec Emergency Physicians of Arizona, LLCGroup PAC ID 6204256084, 155 clinicians

Practice addresses (Care Compare)

9130 E Elliot Rd
Mesa, AZ 85212-9675
Phone (888) 732-3317

Merit-based Incentive Payment System (MIPS)

Final score
85.77 of 100Reported as group
Quality
81.6
Improvement activities
40
Cost
77.61

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tec Emergency Physicians of Arizona, LLC CurrentSince Aug 30, 2025 Accepting new patients
Nextcare Urgent Care Past Accepting new patients

Locations

4760 E Germann Rd
Gilbert, AZ 85297
Phone (480) 494-5000

9130 E Elliot Rd
Mesa, AZ 85212
Phone (480) 410-4500

1419 W Hunt Hwy
San Tan Vly, AZ 85143
Phone (480) 245-4300

5125 S Rural Rd
Tempe, AZ 85282
Phone (480) 306-8780

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1687392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1679259980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20000 N 57TH AVE RM G205",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086872",
            "telephone_number": "845-249-8069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10401 W THUNDERBIRD BLVD",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853513004",
            "telephone_number": "623-832-5366",
            "fax_number": "623-832-7520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BENJAMIN",
        "middle_name": "MITCHELL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-22",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "9760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City, AZ

Sources for this page

Verify at the official NPI Registry.