Lia Monteiro Barbosa

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

21772 S Ellsworth Loop Rd
Queen Creek, AZ 85142-7709

Phone

(480) 512-3700

NPI assigned

May 12, 2023

Reactivated

Apr 17, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Banner Primary Care Physicians Arizona LLCGroup PAC ID 6406020155, 236 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Banner Primary Care Physicians Arizona LLC

  • Primary Care Clinic/Center
  • Phoenix, AZ
  • NPI 1659640902
  Medicare reassignment Care Compare group NPD
• Banner Primary Care Physicians Arizona LLC

  • Primary Care Clinic/Center
  • Phoenix, AZ
  • NPI 1790306066
  NPD
• Banner Primary Care Physicians Arizona LLC

  • Primary Care Clinic/Center
  • Phoenix, AZ
  • NPI 1417238908
  NPD (past)

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

{
    "created_epoch": "1683849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1730879669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11023",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852480001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21772 S ELLSWORTH LOOP RD",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851427709",
            "telephone_number": "480-512-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTEIRO BARBOSA",
        "first_name": "LIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-12",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "deactivation_date": "2024-03-16",
        "reactivation_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trevor Miner, PT
• Andrew G Miritello
• Seyedismail Moayedpardazi, DDS
• Kori Dee Moeller
• Debra Mogler
• Montelena Assisted Living and Memory Care, LLC
• Makenna Montgomery, FNP
• Montoya Pediatric Dentistry LLC Dba San Tan Pediatric Dental
• Stephen J Montoya, DDS
• Charles Gregory Moore, RPH

• Physician Assistant in Queen Creek, AZ
• Providers in Queen Creek, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.