Individual provider Active NPI

Mara Gardner

  • Medical Physician Assistant
  • Mesa, AZ
National Provider Identifier
1740579622
Registry record updated Mar 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
4822 Issued in AZ
Practice address
2310 E Brown Rd
Mesa, AZ 85213-5226
Phone
(480) 649-9000
NPI assigned
Mar 31, 2011
Last updated
Mar 31, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 4822 AZ Primary

Addresses

Primary practice location

2310 E Brown Rd
Mesa, AZ 85213-5226

Mailing address

2310 E Brown Rd
Mesa, AZ 85213-5226
Phone (480) 649-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20250224002782 TX Practitioner - Physician Assistant 1557684933 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

4001 Worth St
Dallas, TX 75246-1608

821 N Coleman St
Suite 100
Prosper, TX 75078-2339
Phone (469) 800-5200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4822AZMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Dec 21, 2024 Accepting new patients
Healthtexas Provider Network CurrentSince Dec 21, 2024 Accepting new patients
Healthtexas Provider Network Past Accepting new patients

Locations

301 N Washington Ave
Fl 5
Dallas, TX 75246
Phone (469) 800-8742

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

Interoperability endpoints

  • Direct secure messaging: mgardner472316@direct.sw.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1301529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301529600000",
    "number": "1740579622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 E BROWN RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852135226",
            "telephone_number": "480-649-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 E BROWN RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852135226",
            "telephone_number": "480-649-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "MARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-31",
        "last_updated": "2011-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "4822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.