Fallon Rayne Damico, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

6188 Issued in AZ

Practice address

9305 W Thomas Rd Ste 285
Phoenix, AZ 85037-3365

Phone

(602) 677-3801

Fax

(877) 569-2006

NPI assigned

Sep 22, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• True Promise Home Health Inc Home health agency, Scottsdale, AZ, CCN 037814
• Banner del E. Webb Medical Center Hospital, Sun City West, AZ, CCN 030093

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GABDDD/Endpoint/GABDDD

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.

• Pura Primary Care

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1750158036
  Medicare reassignment Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Banner del E Webb Medical Center

  • General Acute Care Hospital
  • Sun City West, AZ
  • NPI 1588823553
  Care Compare affiliation
• True Promise Home Health Inc

  • Home Health Agency
  • Scottsdale, AZ
  • NPI 1508423179
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1442880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1942679741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9305 W THOMAS RD STE 285",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850373365",
            "telephone_number": "602-677-3801",
            "fax_number": "877-569-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9305 W THOMAS RD STE 285",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850373365",
            "telephone_number": "602-677-3801",
            "fax_number": "877-569-2006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16838 E Palisades Blvd",
            "address_2": "Bldg C Ste 153",
            "address_purpose": "LOCATION",
            "city": "Fountain Hills",
            "state": "AZ",
            "postal_code": "852683786",
            "country_code": "US",
            "telephone_number": "480-816-3131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAMICO",
        "first_name": "FALLON",
        "middle_name": "RAYNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-22",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "6188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brett A Dameron, DDS
• Jonathan L Dameworth, M.D.
• June Damey
• Andrei Damian, M.D.
• Andreas Damianos, MD
• Amanda Damon, CPNP
• Ruben A Damous, P.A.
• Troy Lee Damper
• Dan Rodda, DDS, PLLC (Complete Dental Care)
• Stephen Dan

• Medical Physician Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.