Individual provider Active NPI

Therese John McCalden

  • Physician Assistant
  • Surprise, AZ
National Provider Identifier
1710693353
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
16928 W Bell Rd Ste 701
Surprise, AZ 85374-8948
Phone
(623) 850-0026
Fax
(623) 850-0027
NPI assigned
Jan 26, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

16928 W Bell Rd Ste 701
Surprise, AZ 85374-8948

Mailing address

16928 W Bell Rd Ste 701
Surprise, AZ 85374-8948
Phone (623) 850-0026

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
I20240206004790 AZ Practitioner - Physician Assistant 2567805542 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Indiana Medical College, School of Medicine of Purdue University, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Banner - University Primary Care Physicians LLCGroup PAC ID 2365746450, 45 clinicians

Practice addresses (Care Compare)

1300 N 12TH St
Phoenix, AZ 85006-2849

4200 E Camelback Rd
Suite 202
Phoenix, AZ 85018-2718
Phone (602) 229-2200

Hospital & facility affiliations

  • Banner - University Medical Center Phoenix Hospital, Phoenix, AZ, CCN 030002

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner - University Medical Center Phoenix Past Accepting new patients

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1674691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1710693353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16928 W BELL RD STE 701",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853748948",
            "telephone_number": "623-850-0026",
            "fax_number": "623-850-0027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16928 W BELL RD STE 701",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853748948",
            "telephone_number": "623-850-0026",
            "fax_number": "623-850-0027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCALDEN",
        "first_name": "THERESE",
        "middle_name": "JOHN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-26",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

Verify at the official NPI Registry.