Individual provider Active NPI

Sydney Rose Vrecenar

  • Physician Assistant
  • Mesa, AZ
National Provider Identifier
1700549722
Registry record updated Dec 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2945 S Dobson Rd
Mesa, AZ 85202-7941
Phone
(480) 969-4138
Fax
(480) 969-0630
NPI assigned
Oct 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2022

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 Primary

Addresses

Primary practice location

2945 S Dobson Rd
Mesa, AZ 85202-7941

Mailing address

2320 N 3Rd St
Phoenix, AZ 85004-1303
Phone (602) 258-9900

Other practice location 1

5850 E Still Cir
Mesa, AZ 85206-3618
Phone (719) 290-9235

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
I20221115000231 AZ Practitioner - Physician Assistant 5991173411 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arizona Advanced Surgery LLCGroup PAC ID 0547690166, 93 clinicians
Honorhealth AmbulatoryGroup PAC ID 5991603110, 630 clinicians

Practice addresses (Care Compare)

2320 N 3Rd St
Phoenix, AZ 85004-1303
Phone (602) 340-0201

2945 S Dobson Rd
Mesa, AZ 85202-7941
Phone (480) 969-4138

7351 E Osborn Rd
Suite 200B
Scottsdale, AZ 85251-6451
Phone (480) 882-5730

Merit-based Incentive Payment System (MIPS)

Final score
94.9 of 100Reported as group
Promoting interoperability
94
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9463AZMDVeterinarian

Organizations & group practices 2

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": "1634428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1700549722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 N 3RD ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041303",
            "telephone_number": "602-258-9900",
            "fax_number": "602-258-9904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2945 S DOBSON RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852027941",
            "telephone_number": "480-969-4138",
            "fax_number": "480-969-0630"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5850 E Still Cir",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852063618",
            "country_code": "US",
            "telephone_number": "719-290-9235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VRECENAR",
        "first_name": "SYDNEY",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-17",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.