Individual provider Active NPI

Erin Leigh Peitzmeier, PA-C

  • Physician Assistant
  • Mesa, AZ
National Provider Identifier
1992027270
Registry record updated Nov 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4604 Issued in AZ
Practice address
4320 E. Presidio Street #101
Mesa, AZ 85215-1165
Phone
(480) 706-9430
Fax
(480) 378-2273
NPI assigned
Feb 27, 2010
Last updated
Nov 8, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4604 AZ Primary

Addresses

Primary practice location

4320 E. Presidio Street #101
Mesa, AZ 85215-1165

Mailing address

5155 E. Eagle Drive #20730
Mesa, AZ 85277-3031
Phone (480) 706-9430

Other identifiers 2

IdentifierTypeStateIssuer
P01697313OtherAZRAILROAD MEDICARE
518761MedicaidAZ

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
I20100608000444 AZ Practitioner - Physician Assistant 0042340622 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valleywide Surgical Services, LLCGroup PAC ID 0749183259, 5 clinicians

Practice addresses (Care Compare)

4320 E Presidio St
Suite 101
Mesa, AZ 85215-1165
Phone (480) 706-9430

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4604AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Surgical Physicians Assistants Inc Past Accepting new patients
Surgical Professionals, Inc Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1267228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478563200000",
    "number": "1992027270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5155 E. EAGLE DRIVE #20730",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852773031",
            "telephone_number": "480-706-9430",
            "fax_number": "480-378-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 E. PRESIDIO STREET #101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852151165",
            "telephone_number": "480-706-9430",
            "fax_number": "480-378-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEITZMEIER",
        "first_name": "ERIN",
        "middle_name": "LEIGH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-27",
        "last_updated": "2016-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "4604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01697313",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "518761",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.