Individual provider Active NPI

Nicholas Alexander Phillips, PA-C

  • Medical Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1922841808
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
2929 E Thomas Rd
Phoenix, AZ 85016-8034
Phone
(602) 470-5000
NPI assigned
Jun 17, 2024
Last updated
Jun 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

2929 E Thomas Rd
Phoenix, AZ 85016-8034

Mailing address

5115 N 22ND Ave Apt 4
Phoenix, AZ 85015-3130
Phone (970) 589-9289

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
I20240910004014 AZ Practitioner - Physician Assistant 6608316237 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10470AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc CurrentSince Aug 12, 2024 Accepting new patients
District Medical Group, Inc CurrentSince Aug 12, 2024 Accepting new patients

Locations

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

2601 E Roosevelt St
Ste 0D10
Phoenix, AZ 85008

2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

5102 W Campbell Ave
Phoenix, AZ 85031
Phone (623) 848-5000

Interoperability endpoints

  • Direct secure messaging: nphillips271908@direct.valleywisehealth.org

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": "1718582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1922841808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5115 N 22ND AVE APT 4",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850153130",
            "telephone_number": "970-589-9289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2929 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850168034",
            "telephone_number": "602-470-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "NICHOLAS",
        "middle_name": "ALEXANDER",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.