Organization Active NPI

Maricopa Surgical Associates, Inc

  • Adult Health Nurse Practitioner
  • Glendale, AZ
National Provider Identifier
1720280795
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN043432 Issued in AZ
Legal business name
MARICOPA SURGICAL ASSOCIATES, INC
Practice address
8314 N 49TH Dr
Glendale, AZ 85302-6307
Phone
(602) 616-0123
Fax
(623) 847-1140
NPI assigned
Jun 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ann Elizabeth Tyrrell, NPNPI 1023003829
Title
President
Phone
(602) 616-0123

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LA2200X RN043432 AZ Primary

Addresses

Primary practice location

8314 N 49TH Dr
Glendale, AZ 85302-6307

Mailing address

8314 N 49TH Dr
Glendale, AZ 85302-6307
Phone (602) 616-0123

Other identifiers 1

IdentifierTypeStateIssuer
574237MedicaidAZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720280795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8314 N 49TH DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853026307",
            "telephone_number": "602-616-0123",
            "fax_number": "623-847-1140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8314 N 49TH DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853026307",
            "telephone_number": "602-616-0123",
            "fax_number": "623-847-1140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARICOPA SURGICAL ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TYRRELL",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "602-616-0123",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "RN043432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "574237",
            "state": "AZ"
        }
    ],
    "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 Aug 22, 2020; 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.