FLAGSTAFF SURGICAL ASSOCIATES PA (NPI# 1720508138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720508138 |
| Entity Type | Organization |
| Organization Name | FLAGSTAFF SURGICAL ASSOCIATES PA |
| Practice Address |
77 W Forest Avenue Suite 107 Flagstaff AZ 86001-1483 |
| Mailing Address |
Po Box 31210 Flagstaff AZ 86003-1210 |
| Practice Telephone | 9287732257 |
| Practice Fax Number | 9287732287 |
| Mailing Telephone | 9287732222 |
| Mailing Fax Number | 9287735898 |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2017-06-27 |
| Authorized Official Name | NATHAN M TRITLE (SUPERVISING PHYSICIAN) |
| Authorized Official Telephone | 9287732257 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | FLAGSTAFF SURGICAL ASSOCIATES PA |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | RN175242 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | ARIZONA BOARD OF NURSING | AP10065 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114995271 | Flagstaff Surgical Associates Pa | Surgery | 77 W Forest Ave Ste 201, Flagstaff, AZ 86001-1483 | 2006-03-14 |
| Street Address |
77 W FOREST AVENUE SUITE 107 |
| City | FLAGSTAFF |
| State | AZ |
| Zip Code | 86001-1483 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275588659 | Northern Arizona Radiology PC | Nuclear Medicine | 77 W Forest Avenue, Suite 101, Flagstaff, AZ 86001-1482 | 2006-05-23 |
| 1497700579 | Stephen V. Ward | Radiology | 77 W Forest Avenue, Suite 101, Flagstaff, AZ 86001-1482 | 2006-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658756 | Marlenne Adair Escobar-mendoza | Specialist/Technologist | 1705 South San Francisco Street, Flagstaff, AZ 86001 | 2020-10-27 |
| 1962033712 | Laura-lee Prescott | Social Worker | Northern Az Va Healthcare System, Flagstaff Cboc, 1300 W. University Ave., Suite 300, Flagstaff, AZ 86001 | 2020-01-30 |
| 1194360784 | Trinity Medical Consultants Pllc | Internal Medicine | 1521 N Cliff Drive, Flagstaff, AZ 86001 | 2019-11-07 |
| 1154849610 | Altacare, LLC | Family Medicine | 2700 S Woodlands Village Blvd Ste 700, Flagstaff, AZ 86001 | 2017-09-05 |
| 1487174926 | Lindsey Marie Forstie | Nurse Practitioner | 7263 E Dreamview Trail, Flagstaff, AZ 86001 | 2017-06-26 |
| 1255860763 | Welbrook Senior Living Flagstaff LLC | Skilled Nursing Facility | 1521 N Pine Cliff Dr, Flagstaff, AZ 86001 | 2017-06-08 |
| 1912432675 | Ryan Tiscareno | Specialist/Technologist | 621 West Cherry Ave, Flagstaff, AZ 86001 | 2017-05-01 |
| 1629432380 | Behavioral Consultation Services, Inc. | Clinic/Center | 345 S. River Run Road, Suite 200, Flagstaff, AZ 86001 | 2016-04-08 |
| 1275920928 | Junli Gallagher | Speech-Language Pathologist | 1215 N. Beaver St, Flagstaff, AZ 86001 | 2015-04-21 |
| 1932592599 | Kristen Flugstad Psyd, LLC | Psychologist | 125 East Elm Avenue #203, Flagstaff, AZ 86001 | 2015-03-06 |
| Find all providers in zip 86001 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659894541 | Despina Ciocanel | Nurse Practitioner | 399 S Malpais Ln Ste 108, Flagstaff, AZ 86001-6299 | 2017-07-21 |
| 1487174926 | Lindsey Marie Forstie | Nurse Practitioner | 7263 E Dreamview Trail, Flagstaff, AZ 86001 | 2017-06-26 |
| 1174954895 | Jill Michelle Dubravcic | Nurse Practitioner | 710 N. Beaver St. #6, Flagstaff, AZ 86001 | 2013-12-05 |
| 1578797122 | Wyatt Woodard Msn Fnp Pllc | Nurse Practitioner | 320 N. Leroux, Suite B, Flagstaff, AZ 86001-4535 | 2009-05-12 |
| 1750339974 | Amy R Knox | Nurse Practitioner | S Sanfransisco and Dome Access, Building 41 Northern Arizona University Campus, Flagstaff, AZ 86011-0001 | 2006-05-04 |
| 1821079542 | Kathy Sherman | Nurse Practitioner | 3150 E Winding Brook Rd, Flagstaff, AZ 86001 | 2005-11-09 |
| 1851952162 | Samuel Small | Nurse Practitioner | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2019-06-26 |
| 1245715028 | Annika Maria Leena Kariniemi | Nurse Practitioner | 940 N Switzer Canyon Dr Ste 102, Flagstaff, AZ 86001-4852 | 2018-09-27 |
| 1417471079 | Julie Marie Ignace | Nurse Practitioner | 1100 N San Francisco St Ste B, Flagstaff, AZ 86001-3260 | 2017-07-26 |
| 1194113399 | Elisa Hilburn | Nurse Practitioner | 2000 S Thompson St, Flagstaff, AZ 86001 | 2014-12-23 |
| Find all providers in FLAGSTAFF | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.