NPIMap

Organization Active NPI

Plastic Surgeons of Northern Arizona, PLLC

  • Specialist
  • Flagstaff, AZ
National Provider Identifier
1871531418
Registry record updated Jul 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
07447612F Issued in AZ
Legal business name
PLASTIC SURGEONS OF NORTHERN ARIZONA, PLLC
Practice address
1020 N San Francisco St
Suite 100
Flagstaff, AZ 86001-3281
Phone
(928) 774-2300
Fax
(928) 214-2137
NPI assigned
Jun 4, 2006
Last updated
Jul 25, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2007

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

Authorized official

Name
Mr. Steven T Schwartz
Title
Administrator
Phone
(928) 774-2300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 07447612F AZ Primary

Addresses

Primary practice location

1020 N San Francisco St
Suite 100
Flagstaff, AZ 86001-3281

Mailing address

1020 N San Francisco St
Suite 100
Flagstaff, AZ 86001-3281
Phone (928) 774-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040211000614 AZ Part B Supplier - Clinic/Group Practice 8224922182 Receives reassigned benefits from 7 practitioners
3 other NPIs on this enrollment
Practice locations: Sedona, AZ; Prescott, AZ; Kingman, AZ; Flagstaff, AZ; Cottonwood, AZ

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1020 N San Francisco St
#200
Flagstaff, AZ 86001
Phone (928) 774-2300

1020 N San Francisco St
Ste 100
Flagstaff, AZ 86001
Phone (928) 774-2300

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185321600000",
    "number": "1871531418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 N SAN FRANCISCO ST",
            "address_2": "SUITE 100",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013281",
            "telephone_number": "928-774-2300",
            "fax_number": "928-214-2137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 N SAN FRANCISCO ST",
            "address_2": "SUITE 100",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013281",
            "telephone_number": "928-774-2300",
            "fax_number": "928-214-2137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC SURGEONS OF NORTHERN ARIZONA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2007-07-25",
        "status": "A",
        "authorized_official_last_name": "SCHWARTZ",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "928-774-2300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AZ",
            "license": "07447612F",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.