Active NPI
Marios Mylonas
- Physician Assistant
- Phoenix, AZ
National Provider Identifier
1770142861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 7661
- Practice address
- 1701 E Colter St Unit 209
Phoenix, AZ 85016-3374 - Phone
- (480) 980-5459
- NPI assigned
- Jun 11, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 7661 | AZ | Primary |
Addresses
Primary practice location
1701 E Colter St Unit 209
Phoenix, AZ 85016-3374
Mailing address
1701 E Colter St Unit 209
Phoenix, AZ 85016-3374
Phone (480) 980-5459
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7661 | AZ | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Honorhealth | Current | Accepting new patients | |
| Honorhealth | Current | Accepting new patients | |
| Scottsdale Emergency Associates, LTD. | Physician Assistant | Current | Accepting new patients |
Locations
5316 E Shea Blvd
Ste 150
Scottsdale, AZ 85254
Phone (480) 534-4530
7400 E Osborn Rd
Scottsdale, AZ 85251
Phone (480) 481-4000
Organizations & group practices 6
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.
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-
- Surgery Physician
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- NPI 1801092564
-
- Emergency Medicine Physician
- Scottsdale, AZ
- NPI 1083671432
-
- Prosthetic/Orthotic Supplier
- Peoria, AZ
- NPI 1386456762
-
- General Acute Care Hospital
- Phoenix, AZ
- NPI 1770690695
-
- Emergency Medicine Physician
- Scottsdale, AZ
- NPI 1023298551
Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681344000000",
"number": "1770142861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1701 E COLTER ST UNIT 209",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850163374",
"telephone_number": "480-980-5459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 E COLTER ST UNIT 209",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850163374",
"telephone_number": "480-980-5459"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MYLONAS",
"first_name": "MARIOS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-11",
"last_updated": "2023-04-13",
"certification_date": "2023-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "7661",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.