Individual provider Active NPI

Nathan Tirrell, PA-C

  • Physician Assistant
  • Surprise, AZ
National Provider Identifier
1780358440
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
13995 W Statler Blvd Ste 200
Surprise, AZ 85374-5503
Phone
(623) 478-3100
NPI assigned
Aug 5, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

13995 W Statler Blvd Ste 200
Surprise, AZ 85374-5503

Mailing address

13995 W Statler Blvd Ste 200
Surprise, AZ 85374-5503
Phone (623) 478-3100

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211104002965 AZ Practitioner - Physician Assistant 9436548849 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10401 W Thunderbird Blvd
Sun City, AZ 85351-3004
Phone (623) 832-4000

13995 W Statler Blvd
BLDG 1
Surprise, AZ 85374-5501
Phone (623) 478-3100

14416 W Meeker Blvd
Sun City, AZ 85375-5284
Phone (623) 876-3800

14502 W Meeker Blvd
Banner Health Clinic
Sun City West, AZ 85375-5282
Phone (623) 524-4000

9165 W Thunderbird Rd
Suite 200
Peoria, AZ 85381-4847
Phone (623) 285-1120

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Physician Specialists Arizona LLC CurrentSince Oct 20, 2021 Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Oct 20, 2021 Accepting new patients
Banner Physician Specialists Arizona LLC Current Accepting new patients
Banner Primary Care Physicians Arizona LLC CurrentSince Oct 20, 2021 Accepting new patients

Locations

9165 W Thunderbird Rd
Ste 200
Peoria, AZ 85381
Phone (623) 285-1120

13640 N Plaza del Rio Blvd
Peoria, AZ 85381
Phone (623) 876-3800

9165 W Thunderbird Rd
Ste 100
Peoria, AZ 85381
Phone (623) 523-6560

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

13995 W Statler Blvd
Ste 200
Surprise, AZ 85374
Phone (602) 478-3100

13995 W Statler Blvd
Bldg 1
Surprise, AZ 85374
Phone (623) 478-3100

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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": "1628121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1780358440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13995 W STATLER BLVD STE 200",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853745503",
            "telephone_number": "623-478-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13995 W STATLER BLVD STE 200",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853745503",
            "telephone_number": "623-478-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIRRELL",
        "first_name": "NATHAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-05",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

Verify at the official NPI Registry.