Individual provider Active NPI

Justine Morgan Danielson

  • Physician Assistant
  • Mesa, AZ
National Provider Identifier
1811600075
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9722 Issued in AZ
Practice address
6553 E Baywood Ave Ste 101
Mesa, AZ 85206-1753
Phone
(480) 543-6750
NPI assigned
Jan 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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 9722 AZ Primary

Addresses

Primary practice location

6553 E Baywood Ave Ste 101
Mesa, AZ 85206-1753

Mailing address

PO Box 12223
Tempe, AZ 85284-0038

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
I20230823002232 AZ Practitioner - Physician Assistant 4587027669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
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

6553 E Baywood Ave
Suite 212
Mesa, AZ 85206-1754
Phone (480) 543-6880

6644 E Baywood Ave
Banner Health Clinic
Mesa, AZ 85206-1747
Phone (480) 321-2000

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

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.12 of 100Reported as group
Quality
76.35
Promoting interoperability
99
Improvement activities
40
Cost
71.55

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Physician Specialists Arizona LLC CurrentSince Sep 1, 2023 Accepting new patients
Banner Physician Specialists Arizona LLC Current Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Sep 1, 2023 Accepting new patients

Locations

1435 S Alma School Rd
Chandler, AZ 85286
Phone (480) 668-1600

155 E Warner Rd
Gilbert, AZ 85296
Phone (480) 649-6600

1920 N Higley Rd
Ste 308
Gilbert, AZ 85234
Phone (480) 543-6600

6553 E Baywood Ave
Ste 101
Mesa, AZ 85206
Phone (480) 543-6750

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

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

Organizations & group practices 3

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 1

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": "1672704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1811600075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12223",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852840038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6553 E BAYWOOD AVE STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061753",
            "telephone_number": "480-543-6750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELSON",
        "first_name": "JUSTINE",
        "middle_name": "MORGAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-03",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "9722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.