Individual provider Active NPI

Megan Elizabeth Ahmed, PA-C

  • Medical Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1962802736
Registry record updated Oct 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
6715 Issued in AZ
Practice address
1 Norterra Dr
Phoenix, AZ 85085-8204
Phone
(623) 715-7055
NPI assigned
Aug 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2017

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 6715 AZ Primary

Addresses

Primary practice location

1 Norterra Dr
Phoenix, AZ 85085-8204

Mailing address

7463 W Lone Cactus Dr
Glendale, AZ 85308-9519

Other names 1

  • Megan Elizabeth Waterkotte Former name

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
I20190227001481 AZ Practitioner - Physician Assistant 4082953559 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Banner Primary Care Physicians Arizona LLCGroup PAC ID 6406020155, 236 clinicians

Practice addresses (Care Compare)

13640 N Plaza del Rio Blvd
Peoria, AZ 85381-4846
Phone (623) 876-3800

4530 E Ray Rd
Suite 190
Phoenix, AZ 85044-6098
Phone (480) 827-5420

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6715AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Good Health Medical, PLLC CurrentSince Oct 18, 2019 Accepting new patients
Banner Primary Care Physicians Arizona LLC CurrentSince Feb 3, 2019 Accepting new patients
Good Health Medical, PLLC CurrentSince Oct 18, 2019 Accepting new patients
Premise Health of Arizona Medical PC PastSince Jan 1, 2020 Accepting new patients
Momentum Physical & Sports Rehabilitation Limited Partnership Past Accepting new patients
Banner Primary Care Physicians Arizona LLC Past Accepting new patients

Locations

3100 N Alma School Rd
Chandler, AZ 85224
Phone (480) 255-5983

428 S Gilbert Rd
Ste 101
Gilbert, AZ 85296
Phone (480) 632-7400

1982 W Main St
Ste 101
Mesa, AZ 85201
Phone (480) 295-4880

1035 N Ellsworth Rd
Ste 108
Mesa, AZ 85207
Phone (480) 305-2888

117 E Main St
Ste A100
Payson, AZ 85541
Phone (928) 474-1714

13640 N Plaza del Rio Blvd
Peoria, AZ 85381
Phone (623) 876-3800

4530 E Ray Rd
Ste 150
Phoenix, AZ 85044
Phone (480) 503-3344

2640 W Baseline Rd
Ste 111
Phoenix, AZ 85041
Phone 4803052888 ext. 1109

4530 E Ray Rd
Ste 190
Phoenix, AZ 85044
Phone (480) 785-0305

287 E Hunt Hwy
Ste 105
San Tan Valley, AZ 85143
Phone (480) 667-8282

14416 W Meeker Blvd
Sun City West, AZ 85375
Phone (623) 583-5083

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1409270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508371200000",
    "number": "1962802736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7463 W LONE CACTUS DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853089519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 NORTERRA DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850858204",
            "telephone_number": "623-715-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "MEGAN",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-29",
        "last_updated": "2017-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "6715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "WATERKOTTE",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.