Active NPI
Tara Griesemer, PA-C
- Physician Assistant
- Gilbert, AZ
National Provider Identifier
1972274157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 11445
- Practice address
- 2946 E Banner Gateway Dr
Gilbert, AZ 85234 - Phone
- (480) 256-6444
- Fax
- (480) 256-3682
- NPI assigned
- Sep 27, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 11445 | AZ | Primary |
Addresses
Primary practice location
2946 E Banner Gateway Dr
Gilbert, AZ 85234
Mailing address
2946 E Banner Gateway Dr
Gilbert, AZ 85234
Phone (480) 256-6444
Other practice location 1
980 Johnson Fy Rd NE
Atlanta, GA 30342-1626
Phone (602) 999-8481
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
525 W Brown Rd
Mesa, AZ 85201-3202
911 S Kachina
Mesa, AZ 85204-4424
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11445 | AZ | MD | Physician Assistant |
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781568000000",
"number": "1972274157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2946 E BANNER GATEWAY DR",
"city": "GILBERT",
"state": "AZ",
"postal_code": "85234",
"telephone_number": "480-256-6444",
"fax_number": "480-256-3682"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2946 E BANNER GATEWAY DR",
"city": "GILBERT",
"state": "AZ",
"postal_code": "85234",
"telephone_number": "480-256-6444",
"fax_number": "480-256-3682"
}
],
"practiceLocations": [
{
"address_1": "980 Johnson Fy Rd NE",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303421626",
"country_code": "US",
"telephone_number": "602-999-8481",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GRIESEMER",
"first_name": "TARA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-27",
"last_updated": "2026-06-16",
"certification_date": "2026-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "11445",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gilbert, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2026; 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.