Individual provider Active NPI

Jean Ernst Noel

  • Physician Assistant
  • Peoria, AZ
National Provider Identifier
1982254876
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8330 Issued in AZ
Practice address
6739 W Cactus Rd
Peoria, AZ 85381-5311
Phone
(833) 242-0100
NPI assigned
Sep 12, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NJDCATEMP-000692 NJ
Surgical Assistant 246ZC0007X 21-302 WI
Physician Assistant 363A00000X 429-P.A. PR
Physician Assistant 363A00000X NJDCATEMP-000305 NJ
Physician Assistant 363A00000X 8330 AZ Primary

Addresses

Primary practice location

6739 W Cactus Rd
Peoria, AZ 85381-5311

Mailing address

6739 W Cactus Rd
Peoria, AZ 85381-5311
Phone (833) 242-0100

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
I20220324000995 AZ Practitioner - Physician Assistant 9739574948 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Angels Valley Community Healthcare Center PLLCGroup PAC ID 8628452927, 2 clinicians

Practice addresses (Care Compare)

14820 N Cave Creek Rd
Suite 2
Phoenix, AZ 85032-4951
Phone (833) 599-6507

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NJDCATEMP-000692NJMDFamily Medicine Physician
21-302WIMDSurgical Assistant
8330AZMDPhysician Assistant
NJDCATEMP-000305NJMDPhysician Assistant
429-P.A.PRMDPhysician 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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1568246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1982254876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6739 W CACTUS RD",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815311",
            "telephone_number": "833-242-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6739 W CACTUS RD",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815311",
            "telephone_number": "833-242-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOEL",
        "first_name": "JEAN",
        "middle_name": "ERNST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-12",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "NJDCATEMP-000692",
            "primary": false
        },
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "WI",
            "license": "21-302",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PR",
            "license": "429-P.A.",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "NJDCATEMP-000305",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "8330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.