Individual provider Active NPI

Laura Mather, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1871065896
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7260 Issued in AZ
Practice address
9520 W Palm LN Ste 115
Phoenix, AZ 85037-4403
Phone
(480) 556-0446
Fax
(480) 556-0447
NPI assigned
Jan 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 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 7260 AZ Primary

Addresses

Primary practice location

9520 W Palm LN Ste 115
Phoenix, AZ 85037-4403

Mailing address

1450 S Dobson Rd Ste A200
Mesa, AZ 85202-4742
Phone (480) 629-5167

Other practice location 1

1450 S Dobson Rd Ste A200
Mesa, AZ 85202-4742
Phone (480) 629-5167

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
I20190320001196 AZ Practitioner - Physician Assistant 1951641455 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richard Lee Averitte Jr PLLCGroup PAC ID 9638069099, 31 clinicians

Practice addresses (Care Compare)

20401 N 73Rd St
Scottsdale, AZ 85255-4153
Phone (480) 556-0446

9520 W Palm LN
Suite 115
Phoenix, AZ 85037-4403
Phone (480) 556-0446

National Provider Directory

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1546387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1871065896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 S DOBSON RD STE A200",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024742",
            "telephone_number": "480-629-5167",
            "fax_number": "480-912-1068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9520 W PALM LN STE 115",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850374403",
            "telephone_number": "480-556-0446",
            "fax_number": "480-556-0447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1450 S Dobson Rd Ste A200",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852024742",
            "country_code": "US",
            "telephone_number": "480-629-5167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHER",
        "first_name": "LAURA",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-02",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "7260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.