Renovation Surgical Assists, LLC

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

Legal business name

RENOVATION SURGICAL ASSISTS, LLC

Practice address

10290 N 92ND St Ste 200
Scottsdale, AZ 85258-4528

Phone

(602) 767-4732

Fax

(602) 351-5660

NPI assigned

Dec 16, 2021

Last updated

Dec 16, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Vanessa Koziol

Title

Credentialing

Phone

(480) 376-6456

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 2

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Daniel D Galat Jr., M.D.

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Scottsdale, AZ
  • NPI 1104803949

  Single Specialty

  NPD
• Benjamin Albert, M.D.

  • Orthopaedic Surgery Physician
  • Scottsdale, AZ
  • NPI 1235494741
  NPD (past)
• Heather Ann Miyashiro, PA-C

  • Physician Assistant
  • Phoenix, AZ
  • NPI 1922516483
  NPD (past)
• Gabriela Maria Stoian, NP

  • Nurse Practitioner
  • Scottsdale, AZ
  • NPI 1649180100
  NPD (past)

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

{
    "created_epoch": "1639612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639612800000",
    "number": "1770242802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4340 E INDIAN SCHOOL RD # 270",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850185360",
            "telephone_number": "602-767-4732",
            "fax_number": "602-351-5660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10290 N 92ND ST STE 200",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584528",
            "telephone_number": "602-767-4732",
            "fax_number": "602-351-5660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20401 N 73rd St Ste 155",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852554149",
            "country_code": "US",
            "telephone_number": "602-767-4732",
            "fax_number": "602-351-5660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RENOVATION SURGICAL ASSISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-16",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A",
        "authorized_official_last_name": "KOZIOL",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "480-376-6456"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@eamedbill.com",
            "affiliation": "N",
            "address_1": "10290 N 92nd St Ste 200",
            "city": "Scottsdale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852584528",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@eamedbill.com",
            "affiliation": "N",
            "address_1": "20401 N 73rd St Ste 155",
            "city": "Scottsdale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852554149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• John Renfrew
• Amy Elizabeth Rengel, SLPA
• Peter-John Frank Rennie
• Renova Diagnostics LLC
• Renovation Orthopaedics, LLC
• Janae Nicole Rensvold, FNP
• Krystal Marie Renszel, DO
• Renuka P Kumar DDS
• Bobbie Lynn Repp, RDH
• Repro Surgical, LLC

• Surgical Assistant in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Surgical Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; 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.