Individual provider Active NPI

Theresa Pak, DO

  • Orthopaedic Surgery Physician
  • Sun City, AZ
National Provider Identifier
1922536630
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
10531 Issued in AZ
Practice address
10484 W Thunderbird Blvd Ste 100
Sun City, AZ 85351-6019
Phone
(866) 974-2673
Fax
(866) 939-2673
NPI assigned
May 24, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X DO209585 OR
Orthopaedic Surgery Physician 207X00000X 10531 AZ Primary

Addresses

Primary practice location

10484 W Thunderbird Blvd Ste 100
Sun City, AZ 85351-6019

Mailing address

18444 N 25TH Ave Ste 310
Phoenix, AZ 85023-1266
Phone (866) 974-2673

Other identifiers 1

IdentifierTypeStateIssuer
138301MedicaidAZ

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
I20230908000232 AZ Practitioner - Orthopedic Surgery 4880073881 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Touro Un Col of Osteopathic Medicine, New York, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

18444 N 25TH Ave
Suite 210
Phoenix, AZ 85023-1264
Phone (866) 974-2673

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.13 of 100Reported as individual
Quality
74.78
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)71
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10531AZMDOrthopaedic Surgery Physician
DO209585ORMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Orthopedic Research and Education LLC CurrentSince Sep 1, 2023 Accepting new patients
Center for Orthopedic Research and Education, LLC Orthopaedic Surgery Current Accepting new patients
Center for Orthopedic Research and Educatoin CurrentSince Sep 1, 2023 Accepting new patients

Locations

3591 S Mercy Rd
Ste 204
Gilbert, AZ 85297
Phone (869) 742-6736

9321 W Thomas Rd
Ste 205
Phoenix, AZ 85037

18444 N 25th Ave
Ste 310
Phoenix, AZ 85023
Phone (623) 241-8706

18444 N 25th Ave
Ste 210
Phoenix, AZ 85023
Phone (669) 742-6738

10484 W Thunderbird Blvd
Ste 100
Sun City, AZ 85351
Phone (669) 742-6738

10494 W Thunderbird Blvd
Ste 102
Sun City, AZ 85351
Phone (623) 975-8311

10484 W Thunderbird Blvd
#100
Sun City, AZ 85351

Interoperability endpoints

  • Direct secure messaging: theresa.pak.1@22724.direct.athenahealth.com
  • Direct secure messaging: tpak135230@direct.llu.edu

Organizations & group practices 3

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 2

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": "1495584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1922536630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18444 N 25TH AVE STE 310",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850231266",
            "telephone_number": "866-974-2673",
            "fax_number": "866-939-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10484 W THUNDERBIRD BLVD STE 100",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853516019",
            "telephone_number": "866-974-2673",
            "fax_number": "866-939-2673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAK",
        "first_name": "THERESA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-24",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OR",
            "license": "DO209585",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "10531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138301",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City, AZ

Sources for this page

Verify at the official NPI Registry.