Individual provider Active NPI

Tiana Rae Siragusa, PA-C

  • Physician Assistant
  • Glendale, AZ
National Provider Identifier
1699698555
Registry record updated Jul 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11953 Issued in AZ
Practice address
19555 N 59TH Ave
Glendale, AZ 85308-6813
Phone
(623) 572-3125
NPI assigned
Jul 30, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 11953 AZ Primary

Addresses

Primary practice location

19555 N 59TH Ave
Glendale, AZ 85308-6813

Mailing address

7438 E Cactus Wren Rd
Scottsdale, AZ 85250-4603
Phone (602) 741-7410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1785369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785369600000",
    "number": "1699698555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7438 E CACTUS WREN RD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852504603",
            "telephone_number": "602-741-7410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19555 N 59TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086813",
            "telephone_number": "623-572-3125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRAGUSA",
        "first_name": "TIANA",
        "middle_name": "RAE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-30",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "11953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.