Individual provider Active NPI

Michael Steven Elson II, PA-C

  • Physician Assistant
  • Kettering, OH
National Provider Identifier
1891214300
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.005171RX Issued in OH
Practice address
3535 Southern Blvd
Kettering, OH 45429-1221
Phone
(937) 395-8166
NPI assigned
Sep 15, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2023

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 7434 AZ
Physician Assistant 363A00000X 50.005171RX OH Primary

Addresses

Primary practice location

3535 Southern Blvd
Kettering, OH 45429-1221

Mailing address

3131 Newmark Dr Ste 220
Miamisburg, OH 45342-5400
Phone (937) 438-8910

Other practice location 1

3535 Pentagon Blvd
Beavercreek, OH 45431-1705
Phone (937) 702-4500

Other practice location 2

100 Kettering Way
Franklin, OH 45005-1155
Phone (937) 458-4700

Other practice location 3

1141 N Monroe Dr
Xenia, OH 45385-1619
Phone (937) 352-2500

Other practice location 4

8701 Old Troy Pike
Huber Heights, OH 45424-1066
Phone (937) 558-3338

Other practice location 5

4000 Miamisburg Centerville Rd
Miamisburg, OH 45342-7615
Phone (937) 384-8791

Other practice location 6

1997 Miamisburg Centerville Rd
Centerville, OH 45459-3811
Phone (937) 401-6228

Other practice location 7

6147 State Route 122
Middletown, OH 45005-5201
Phone (513) 261-3419

Other practice location 8

450 Washington Jackson Rd
Eaton, OH 45320-8699
Phone (937) 456-8376

Other practice location 9

405 W Grand Ave
Dayton, OH 45405-7538
Phone (937) 723-3211

Other identifiers 1

IdentifierTypeStateIssuer
0248621MedicaidOH

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
I20191002001972 AZ Practitioner - Physician Assistant 4981960903 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

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

126 E Main St
Suite D
Payson, AZ 85541-5488
Phone (928) 596-4800

807 S Ponderosa St
Payson, AZ 85541-5542
Phone (928) 471-3222

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7434AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Urgent Care Services, LLC CurrentSince Dec 20, 2019 Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Nov 10, 2024 Accepting new patients
Banner Urgent Care Services, LLC CurrentSince Dec 20, 2019 Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Nov 10, 2024 Accepting new patients

Locations (25 of 49)

11685 W Van Buren St
Avondale, AZ 85323
Phone (623) 465-6420

1676 E McMurray Blvd
Ste 1
Casa Grande, AZ 85122
Phone (520) 316-0688

2950 S Alma School Rd
Ste 1
Chandler, AZ 85286
Phone (480) 821-2028

3200 S Gilbert Rd
Chandler, AZ 85286
Phone (480) 471-6404

3000 N Arizona Ave
Chandler, AZ 85225
Phone (480) 355-1575

3160 E Queen Creek Rd
Gilbert, AZ 85297
Phone (480) 827-5790

1660 N Higley Rd
Ste 104
Gilbert, AZ 85234
Phone (480) 827-5600

1641 E Guadalupe Rd
Gilbert, AZ 85234
Phone (480) 813-4233

641 W Warner Rd
Gilbert, AZ 85233
Phone (480) 722-9828

3126 S Higley Rd
Ste 109
Gilbert, AZ 85295
Phone (480) 436-8102

1355 S Higley Rd
Ste 104
Gilbert, AZ 85296
Phone (480) 499-0201

4232 W Bell Rd
Glendale, AZ 85308
Phone (602) 639-4535

7952 N 43rd Ave
Glendale, AZ 85301
Phone (623) 465-6330

6702 W Bethany Home Rd
Ste 1315
Glendale, AZ 85303
Phone (623) 435-7000

3328 N Litchfield Rd
Goodyear, AZ 85395
Phone (623) 239-0394

16430 W Yuma Rd
Goodyear, AZ 85338
Phone (623) 465-6405

1121 S Gilbert Rd
Ste 101
Mesa, AZ 85204
Phone (480) 644-9355

407 N Lindsay Rd
Ste 103
Mesa, AZ 85213
Phone (480) 807-0084

1955 W Guadalupe Rd
Ste 1
Mesa, AZ 85202
Phone (480) 207-2990

1157 S Crismon Rd
Ste 101
Mesa, AZ 85208
Phone (480) 827-5730

1215 S Higley Rd
Mesa, AZ 85206
Phone (480) 218-4022

1120 S Gilbert Rd
Mesa, AZ 85204
Phone (480) 558-5278

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

1908 E McKellips Rd
Mesa, AZ 85203
Phone (480) 827-5610

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

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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": "1505433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1891214300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 NEWMARK DR STE 220",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453425400",
            "telephone_number": "937-438-8910",
            "fax_number": "937-436-4984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 SOUTHERN BLVD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291221",
            "telephone_number": "937-395-8166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3535 Pentagon Blvd",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "454311705",
            "country_code": "US",
            "telephone_number": "937-702-4500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Kettering Way",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "OH",
            "postal_code": "450051155",
            "country_code": "US",
            "telephone_number": "937-458-4700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1141 N Monroe Dr",
            "address_purpose": "LOCATION",
            "city": "Xenia",
            "state": "OH",
            "postal_code": "453851619",
            "country_code": "US",
            "telephone_number": "937-352-2500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8701 Old Troy Pike",
            "address_purpose": "LOCATION",
            "city": "Huber Heights",
            "state": "OH",
            "postal_code": "454241066",
            "country_code": "US",
            "telephone_number": "937-558-3338",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4000 Miamisburg Centerville Rd",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453427615",
            "country_code": "US",
            "telephone_number": "937-384-8791",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1997 Miamisburg Centerville Rd",
            "address_purpose": "LOCATION",
            "city": "Centerville",
            "state": "OH",
            "postal_code": "454593811",
            "country_code": "US",
            "telephone_number": "937-401-6228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6147 State Route 122",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "OH",
            "postal_code": "450055201",
            "country_code": "US",
            "telephone_number": "513-261-3419",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "450 Washington Jackson Rd",
            "address_purpose": "LOCATION",
            "city": "Eaton",
            "state": "OH",
            "postal_code": "453208699",
            "country_code": "US",
            "telephone_number": "937-456-8376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 W Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454057538",
            "country_code": "US",
            "telephone_number": "937-723-3211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELSON",
        "first_name": "MICHAEL",
        "middle_name": "STEVEN",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-15",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "7434",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.005171RX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0248621",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

Verify at the official NPI Registry.