Individual provider Active NPI

Deborah Joyce Lader, P.A.-C.

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1720086994
Registry record updated Jun 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10387 Issued in AZ
Practice address
3536 W Glendale Ave
Phoenix, AZ 85051-8395
Phone
(480) 618-0177
Fax
(620) 371-2243
NPI assigned
Jul 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2026

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 MA002185L PA
Physician Assistant 363A00000X 10387 AZ Primary

Addresses

Primary practice location

3536 W Glendale Ave
Phoenix, AZ 85051-8395

Mailing address

PO Box 746093
Atlanta, GA 30374-6093
Phone (602) 782-1880

Other practice location 1

1940 W Indian School Rd Ste 1
Phoenix, AZ 85015-5112
Phone (602) 782-1880

Other identifiers 2

IdentifierTypeStateIssuer
50047054OtherKEYSTONE HEALTH CENTRAL
50047054OtherCAPITAL BLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090204000080 NJ Practitioner - Physician Assistant 7416037783 Reassigns benefits to 1 organization
I20241120002465 AZ Practitioner - Physician Assistant 7416037783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oak Street Health Physicians Group of Arizona PLLCGroup PAC ID 3274939988, 76 clinicians

Practice addresses (Care Compare)

1940 W Indian School Rd
Suite 1
Phoenix, AZ 85015-5112
Phone (602) 782-1880

2850 E Main St
Suite 106
Mesa, AZ 85213-9304
Phone (480) 618-0019

Merit-based Incentive Payment System (MIPS)

Final score
95.05 of 100Reported as apm
Quality
85.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10387AZMDPhysician Assistant
MA002185LPAMDPhysician Assistant

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": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781827200000",
    "number": "1720086994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746093",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746093",
            "telephone_number": "602-782-1880",
            "fax_number": "602-671-6915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3536 W GLENDALE AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850518395",
            "telephone_number": "480-618-0177",
            "fax_number": "620-371-2243"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1940 W Indian School Rd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850155112",
            "country_code": "US",
            "telephone_number": "602-782-1880",
            "fax_number": "602-671-6915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LADER",
        "first_name": "DEBORAH",
        "middle_name": "JOYCE",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-12",
        "last_updated": "2026-06-19",
        "certification_date": "2026-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA002185L",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "10387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTH CENTRAL",
            "identifier": "50047054",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50047054",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.