Individual provider Active NPI

Brian D Zilliox, PA-C

  • Medical Physician Assistant
  • Mesa, AZ
National Provider Identifier
1891506804
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
11023 Issued in AZ
Practice address
1935 N Stapley Dr
Mesa, AZ 85203-2749
Phone
(480) 610-4140
NPI assigned
Jan 17, 2025
Last updated
Jun 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 65547 CA
Physician Assistant 363A00000X 11023 AZ
Medical Physician Assistant 363AM0700X 11023 AZ Primary

Addresses

Primary practice location

1935 N Stapley Dr
Mesa, AZ 85203-2749

Mailing address

PO Box 932958
Cleveland, OH 44193-0028
Phone (615) 425-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250221001156 CA Practitioner - Physician Assistant 9638699580 Reassigns benefits to 1 organization
I20250514003528 AZ Practitioner - Physician Assistant 9638699580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Nova Southeastern College of Osteo Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Little Clinic of Arizona LLCGroup PAC ID 4981797982, 43 clinicians

Practice addresses (Care Compare)

2727 W Bell Rd
Phoenix, AZ 85053-3059
Phone (602) 680-2386

9900 S Rural Rd
Tempe, AZ 85284-4116
Phone (480) 783-6257

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
65547CAMDPharmacist
11023AZMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: brian.zilliox@krogerhealth.eclinicaldirectplus.com

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": "1737072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1891506804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932958",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930028",
            "telephone_number": "615-425-4200",
            "fax_number": "615-424-4201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 N STAPLEY DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852032749",
            "telephone_number": "480-610-4140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZILLIOX",
        "first_name": "BRIAN",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-17",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "65547",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "11023",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "11023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.