Individual provider Active NPI

Rebekah Braun

  • Physician Assistant
  • Surprise, AZ
National Provider Identifier
1861218430
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
14725 W Mountain View Blvd
Surprise, AZ 85374-2704
Phone
(623) 243-9077
NPI assigned
Nov 28, 2024
Last updated
Jul 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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 NU Primary

Addresses

Primary practice location

14725 W Mountain View Blvd
Surprise, AZ 85374-2704

Mailing address

14725 W Mountain View Blvd
Surprise, AZ 85374-2704
Phone (623) 243-9077

Other practice location 1

401 W Kennedy Blvd
Tampa, FL 33606-1450
Phone (813) 253-3333

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
I20251212001306 AZ Practitioner - Physician Assistant 5890065866 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Group practices
Regency Skin Institute PLLCGroup PAC ID 5193097665, 14 clinicians

Practice addresses (Care Compare)

10240 W Indian School Rd
Suite 115
Phoenix, AZ 85037-5905
Phone (623) 243-9077

14725 W Mountain View Blvd
Surprise, AZ 85374-2704
Phone (623) 243-9077

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11081AZMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regency Skin Institute PLLC CurrentSince Sep 18, 2025 Accepting new patients
Regency Reconstruction PLLC Past Accepting new patients

Locations

10240 W Indian School Rd
Ste 115
Phoenix, AZ 85037
Phone (623) 243-9077

14725 W Mountain View Blvd
Surprise, AZ 85374
Phone (623) 243-9077

14869 W Bell Rd
Ste 103
Surprise, AZ 85374

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1732752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1861218430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14725 W MOUNTAIN VIEW BLVD",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853742704",
            "telephone_number": "623-243-9077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14725 W MOUNTAIN VIEW BLVD",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853742704",
            "telephone_number": "623-243-9077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 W Kennedy Blvd",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336061450",
            "country_code": "US",
            "telephone_number": "813-253-3333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAUN",
        "first_name": "REBEKAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-28",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

Verify at the official NPI Registry.