Professional Surgical Assistants of Arizona, LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

PROFESSIONAL SURGICAL ASSISTANTS OF ARIZONA, LLC

Practice address

4320 E. Presidio St.
#101
Mesa, AZ 85215

Phone

(480) 706-9430

NPI assigned

Oct 20, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Megan Christensen

Title

Coo

Phone

(480) 706-9430

Specialties & licenses 2

Addresses

Other names 1

• Professional Surgical Services Doing business as

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

{
    "created_epoch": "1319068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537401600000",
    "number": "1972888089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5155 E EAGLE DR UNIT 20730",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852773031",
            "telephone_number": "480-706-9430",
            "fax_number": "480-223-6206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 E. PRESIDIO ST.",
            "address_2": "#101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85215",
            "telephone_number": "480-706-9430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL SURGICAL ASSISTANTS OF ARIZONA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-20",
        "last_updated": "2018-09-20",
        "status": "A",
        "authorized_official_last_name": "CHRISTENSEN",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "480-706-9430",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Professional Surgical Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Professional Surgical Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Mesa, AZ
• Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.