Individual provider Active NPI

Abby Michele Nasternak, PA C

  • Medical Physician Assistant
  • Glendale, AZ
National Provider Identifier
1689645467
Registry record updated Jan 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
3033 Issued in AZ
Practice address
9494 W Northern Ave
101
Glendale, AZ 85305-1118
Phone
(623) 872-2226
NPI assigned
Jan 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 3033 AZ Primary

Addresses

Primary practice location

9494 W Northern Ave
101
Glendale, AZ 85305-1118

Mailing address

2550 N Thunderbird Cir
Mesa, AZ 85215-1214
Phone (480) 353-2235

Other identifiers 1

IdentifierTypeStateIssuer
885048MedicaidAZ

Other names 1

  • Abby Michele Johnson Former name

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
I20041021000813 AZ Practitioner - Physician Assistant 8123007150 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3033AZMDCommunity Health Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Honorhealth Ambulatory CurrentSince May 1, 2019 Accepting new patients
Honorhealth Ambulatory CurrentSince May 1, 2019 Accepting new patients
Punyakam PLLC PastSince Aug 1, 2011 Accepting new patients
Central Arizona Gi & Liver Institute LLC Past Accepting new patients
Reddy Gi Associates PastSince Jan 10, 2021 Accepting new patients
Clinical Associates in Internal Medicine, LTD Past Accepting new patients
Arizona Gastroenterology and Liver Clinic,P.C. Past Accepting new patients

Locations

250 E Dunlap Ave
Phoenix, AZ 85020
Phone (480) 331-6721

19636 N 27th Ave
Ste 408
Phoenix, AZ 85027
Phone (623) 780-0100

2500 W Utopia Rd
Ste 100
Phoenix, AZ 85027
Phone (623) 683-4462

2500 W Utopia Rd
Phoenix, AZ 85027
Phone (602) 812-3080

10510 N 92nd St
Ste 200
Scottsdale, AZ 85258
Phone (480) 323-1250

3501 N Scottsdale Rd
Ste 320
Scottsdale, AZ 85251
Phone (480) 424-7228

Interoperability endpoints

  • Direct secure messaging: abby.nasternak@ospi.directbygreenway.com

Organizations & group practices 9

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": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389657600000",
    "number": "1689645467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 N THUNDERBIRD CIR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852151214",
            "telephone_number": "480-353-2235",
            "fax_number": "480-776-0025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9494 W NORTHERN AVE",
            "address_2": "101",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853051118",
            "telephone_number": "623-872-2226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASTERNAK",
        "first_name": "ABBY",
        "middle_name": "MICHELE",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-30",
        "last_updated": "2014-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "3033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "885048",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABBY",
            "last_name": "JOHNSON",
            "middle_name": "MICHELE",
            "credential": "PA C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.