Individual provider Active NPI

Mario Lant, PA-C

  • Physician Assistant
  • Glendale, AZ
National Provider Identifier
1811651193
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
18700 N 64TH Dr Ste 301
Glendale, AZ 85308-7114
Phone
(623) 748-0145
NPI assigned
Oct 24, 2021
Last updated
Mar 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary
Surgical Physician Assistant 363AS0400X 9455 AZ

Addresses

Primary practice location

18700 N 64TH Dr Ste 301
Glendale, AZ 85308-7114

Mailing address

2910 E Des Moines St
Mesa, AZ 85213-6914
Phone (480) 822-0107

Other practice location 1

485 S Dobson Rd Ste 110
Chandler, AZ 85224-5600
Phone (480) 728-4470

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
I20230626000104 AZ Practitioner - Physician Assistant 4082072947 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

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

120 E Main St
Suite a
Payson, AZ 85541-5618
Phone (928) 596-4700

1900 N Higley Rd
Banner Health Clinic
Gilbert, AZ 85234-1604
Phone (480) 543-2688

37100 N Gantzel Rd
Suite 107
San Tan Valley, AZ 85140-7350
Phone (480) 394-4480

37100 N Gantzel Rd
Suite 201
San Tan Valley, AZ 85140-7352
Phone (480) 394-4469

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner - University Physician Specialists LLC CurrentSince Jan 10, 2025 Accepting new patients
St. Joseph's Hospital and Medical Center CurrentSince Aug 30, 2020 Accepting new patients
Banner Physician Specialists Arizona LLC Current Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Aug 8, 2024 Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Aug 8, 2024 Accepting new patients
VHS Outpatient Clinics, Inc. CurrentSince Jun 1, 2023 Accepting new patients

Locations

1955 W Frye Rd
Chandler, AZ 85224
Phone (480) 507-2961

3235 N Hunt Hwy
Ste 103
Florence, AZ 85132
Phone (520) 233-2770

1920 N Higley Rd
Ste 306
Gilbert, AZ 85234
Phone (480) 543-2606

3555 S Val Vista Dr
Gilbert, AZ 85297
Phone (480) 434-4356

18700 N 64th Dr
Ste 301
Glendale, AZ 85308
Phone (602) 841-0741

5130 W Baseline Rd
Ste 102
Laveen, AZ 85339
Phone (602) 237-0039

1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000

1917 S Crismon Rd
Mesa, AZ 85209
Phone (480) 610-7100

6644 E Baywood Ave
Mesa, AZ 85206
Phone (480) 321-2000

120 E Main St
Ste A
Payson, AZ 85541
Phone (928) 474-9744

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

1300 N 12th St
Ste 508
Phoenix, AZ 85006
Phone (602) 839-3927

37100 N Gantzel Rd
Ste 107
San Tan Vly, AZ 85140
Phone (480) 394-4480

37100 N Gantzel Rd
Ste 201
San Tan Vly, AZ 85140
Phone (480) 394-4469

File 56765
Los Angeles, CA 90074

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1635033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1811651193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 E DES MOINES ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852136914",
            "telephone_number": "480-822-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18700 N 64TH DR STE 301",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853087114",
            "telephone_number": "623-748-0145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "485 S Dobson Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852245600",
            "country_code": "US",
            "telephone_number": "480-728-4470",
            "fax_number": "480-728-4499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANT",
        "first_name": "MARIO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-24",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "9455",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.