Active NPI
Stefan Iacob, PA-C
- Medical Physician Assistant
- Surprise, AZ
National Provider Identifier
1851437503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 3467
- Practice address
- 14239 W Bell Rd Ste 108
Surprise, AZ 85374-2470 - Phone
- (623) 248-4283
- Fax
- (623) 440-4255
- NPI assigned
- Jan 29, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 3467 | AZ | Primary |
Addresses
Primary practice location
14239 W Bell Rd Ste 108
Surprise, AZ 85374-2470
Mailing address
1839 S Alma School Rd Ste 354
Mesa, AZ 85210-3028
Phone (480) 726-2287
Other practice location 1
2919 S Ellsworth Rd Ste 111
Mesa, AZ 85212-2165
Phone (480) 564-1185
Other practice location 2
3130 E Baseline Rd Ste 107
Mesa, AZ 85204-7290
Phone (480) 345-1980
Other practice location 3
20860 N Tatum Blvd Ste 290
Phoenix, AZ 85050-4282
Phone (480) 563-1144
Other practice location 4
2145 E Warner Rd Ste 104
Tempe, AZ 85284-3549
Phone (480) 664-9443
Other practice location 5
15256 N 75th Ave Ste 360
Peoria, AZ 85381-4761
Phone (623) 486-2424
Other practice location 6
1277 E Missouri Ave Ste 101
Phoenix, AZ 85014-2916
Phone (602) 296-4060
Other practice location 7
270 E Hunt Hwy Ste A-2
San Tan Valley, AZ 85143-4962
Phone (480) 882-2222
Other practice location 8
3011 S Lindsay Rd Ste 101
Gilbert, AZ 85295-4333
Phone (480) 726-2500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 438998 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3467 | AZ | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tri-City Express Care, PLLC | Past | Accepting new patients | |
| Tri-City Express Care, PLLC | Single Specialty | Past | Accepting new patients |
| Tri-City Express Care, PLLC | Single Specialty | Past | Accepting new patients |
| Tri-City Express Care, PLLC | Single Specialty | Past | Accepting new patients |
| Tri-City Express Care, PLLC | Past | Accepting new patients | |
| Whispering Palms Medical Inc | Single Specialty | Past | Accepting new patients |
| Banner Sun City Medical Group | Single Specialty | Past | Accepting new patients |
| Privia Medical Group Arizona, LLC | Single Specialty | Past | Accepting new patients |
| Nextcare Urgent Care | Medical | Past | Accepting new patients |
| Banner Urgent Care - Surprise | Single Specialty | Past | Accepting new patients |
| Sun Valley Urology, PC | Single Specialty | Past | Accepting new patients |
| Honorhealth Urgent Care, LLC | Single Specialty | Past | Accepting new patients |
| Tri-City Express Care, PLLC | Past | Accepting new patients |
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Organizations & group practices 13
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.
-
- Multi-Specialty Clinic/Center
- Sun City, AZ
- NPI 1902067200
Single Specialty
-
- Urgent Care Clinic/Center
- Surprise, AZ
- NPI 1649406273
Single Specialty
-
- Family Medicine Physician
- Phoenix, AZ
- NPI 1760441141
Single Specialty
-
- Urgent Care Clinic/Center
- Phoenix, AZ
- NPI 1376981092
-
- Urgent Care Clinic/Center
- Tolleson, AZ
- NPI 1750728523
-
- Urgent Care Clinic/Center
- Phoenix, AZ
- NPI 1972929081
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683072000000",
"number": "1851437503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1839 S ALMA SCHOOL RD STE 354",
"city": "MESA",
"state": "AZ",
"postal_code": "852103028",
"telephone_number": "480-726-2287",
"fax_number": "888-503-3312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14239 W BELL RD STE 108",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853742470",
"telephone_number": "623-248-4283",
"fax_number": "623-440-4255"
}
],
"practiceLocations": [
{
"address_1": "2919 S Ellsworth Rd Ste 111",
"address_purpose": "LOCATION",
"city": "Mesa",
"state": "AZ",
"postal_code": "852122165",
"country_code": "US",
"telephone_number": "480-564-1185",
"fax_number": "480-590-4375",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3130 E Baseline Rd Ste 107",
"address_purpose": "LOCATION",
"city": "Mesa",
"state": "AZ",
"postal_code": "852047290",
"country_code": "US",
"telephone_number": "480-345-1980",
"fax_number": "480-926-1721",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "20860 N Tatum Blvd Ste 290",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850504282",
"country_code": "US",
"telephone_number": "480-563-1144",
"fax_number": "480-563-2371",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2145 E Warner Rd Ste 104",
"address_purpose": "LOCATION",
"city": "Tempe",
"state": "AZ",
"postal_code": "852843549",
"country_code": "US",
"telephone_number": "480-664-9443",
"fax_number": "480-664-9378",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "15256 N 75th Ave Ste 360",
"address_purpose": "LOCATION",
"city": "Peoria",
"state": "AZ",
"postal_code": "853814761",
"country_code": "US",
"telephone_number": "623-486-2424",
"fax_number": "623-486-4324",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1277 E Missouri Ave Ste 101",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850142916",
"country_code": "US",
"telephone_number": "602-296-4060",
"fax_number": "602-296-4146",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "270 E Hunt Hwy Ste A-2",
"address_purpose": "LOCATION",
"city": "San Tan Valley",
"state": "AZ",
"postal_code": "851434962",
"country_code": "US",
"telephone_number": "480-882-2222",
"fax_number": "480-882-2220",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3011 S Lindsay Rd Ste 101",
"address_purpose": "LOCATION",
"city": "Gilbert",
"state": "AZ",
"postal_code": "852954333",
"country_code": "US",
"telephone_number": "480-726-2500",
"fax_number": "480-726-2131",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "IACOB",
"first_name": "STEFAN",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-29",
"last_updated": "2023-05-03",
"certification_date": "2023-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physician Assistant, Medical",
"state": "AZ",
"license": "3467",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "438998",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Surprise, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.