Brian S Allshouse, PA-C
Individual provider Active NPI Surgical Physician Assistant · Prescott, AZ
NPI 1801823372 · NPPES record last updated Nov 5, 2019
Key facts
- NPI
- 1801823372
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Physician Assistant 363AS0400X
- License
- 1951 (AZ)
- Practice address
- 811 Ainsworth Dr
Suite 109
Prescott, AZ 86301-1687 - Phone
- (928) 771-5595
- Fax
- (928) 771-5596
- NPI assigned
- Jun 28, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Yavapai Regional Medical Center Physician Care LLC
Practice addresses (Care Compare)
1003 Willow Creek Rd
Prescott, AZ 86301-1641
3120 Clearwater Dr
Prescott, AZ 86305-7131
Phone (928) 771-3704
Hospital & facility affiliations
- Yavapai Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050519000240 | AZ | Practitioner - Physician Assistant | 9436190550 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1951 | AZ | MD | Clinical Psychologist |
| 1951 | AL | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yavapai Regional Medical Center Physician Care LLC | Current |
Accepting new patients | |
| Nextcare Arizona I JV LLC | Past | Accepting new patients | |
| Prescott Gastroenterology | Past | Accepting new patients |
Locations
1739 E Beverly Ave
Ste 221
Kingman, AZ 86409
Phone (928) 771-5595
1001 Willow Creek Rd
Ste 3200
Prescott, AZ 86301
Phone (928) 771-5595
3120 Clearwater Dr
Prescott, AZ 86305
Phone (928) 445-4818
811 Ainsworth Dr
Ste 109
Prescott, AZ 86301
Phone (928) 771-5595
3262 N Windsong Dr
Ste A
Prescott Valley, AZ 86314
Phone (928) 771-5595
3262 N Windsong Dr
Prescott Valley, AZ 86314
Phone (928) 759-5800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 1951 | AZ | Yes |
Addresses
Primary practice location
811 Ainsworth Dr
Suite 109
Prescott, AZ 86301-1687
Mailing address
PO Box 10880
Prescott, AZ 86304-0880
Phone (928) 759-5987
Other practice location 1
1739 E Beverly Ave Ste 221
Kingman, AZ 86409-3593
Phone (928) 771-5595
Other practice location 2
3262 N Windsong Dr Ste A
Prescott Valley, AZ 86314-2255
Phone (928) 771-5595
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 374009 | Medicaid | AZ |
Other providers in Prescott, AZ
- Laurie Mitchell Allen
- Suzanne D Allen
- William Allen
- Melissa Alley
- Alliance Homecare & Mobile Diagnostics, LLC
- Elise Almagambetova
- Heidi Lynn Alton
- Always Yours LLC
- Amanda Wikan LLC
- Nicole Amato
All providers in Prescott, AZ · Surgical Physician Assistant in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 5, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.