Individual provider Active NPI

Thomas H Hirasa, MD

  • Surgery Physician
  • Prescott, AZ
National Provider Identifier
1922016682
Registry record updated Oct 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
37662 Issued in AZ
Practice address
804 Ainsworth Dr
Suite 103
Prescott, AZ 86301-1624
Phone
(928) 771-1011
Fax
(928) 771-1332
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 37662 AZ Primary

Addresses

Primary practice location

804 Ainsworth Dr
Suite 103
Prescott, AZ 86301-1624

Mailing address

804 Ainsworth Drive
Suite 103
Prescott, AZ 86301-1624
Phone (928) 771-1011

Other identifiers 1

IdentifierTypeStateIssuer
313724MedicaidAZ

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080122000753 AZ Practitioner - General Surgery 6608957147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Loyola University of Chicago, Stritch School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

804 Ainsworth Dr
Suite 103
Prescott, AZ 86301-1624
Phone (928) 771-1011

Hospital & facility affiliations

  • Yavapai Regional Medical Center Hospital, Prescott, AZ, CCN 030012

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)49
Hernia repair (minimally invasive)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
37662AZMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas H. Hirasa, M.D., PLLC Surgery CurrentSince Jan 22, 2010 Accepting new patients

Locations

1003 Willow Creek Rd
Prescott, AZ 86301
Phone (928) 445-2700

804 Ainsworth Dr
Ste 103
Prescott, AZ 86301
Phone (928) 445-2700

810 Ainsworth Dr
Ste A
Prescott, AZ 86301
Phone (928) 771-5548

Organizations & group practices 1

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350000000000",
    "number": "1922016682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 AINSWORTH DRIVE",
            "address_2": "SUITE 103",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011624",
            "telephone_number": "928-771-1011",
            "fax_number": "928-771-1332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 AINSWORTH DR",
            "address_2": "SUITE 103",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011624",
            "telephone_number": "928-771-1011",
            "fax_number": "928-771-1332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIRASA",
        "first_name": "THOMAS",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2012-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "37662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "313724",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.