AMANDA RASCON
NPI 1063157253
Nurse Practitioner - Family in Glendale, AZ

Q: What is Amanda Rascon's NPI number?

The NPI number for Amanda Rascon is 1063157253. It was assigned to this individual provider in the NPPES registry on May 2, 2022.

Q: What is Amanda Rascon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Amanda Rascon was last updated on October 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 02, 2022PECOS EnrolledAccepts Medicare Assignment

11851 N 51ST AVE STE B110, GLENDALE, AZ 85304(480) 882-4545(623) 207-7410 Get Directions Write a Review

NPPES record last updated: October 13, 2025. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Nov 8, 2024, May 2, 2022 (2 updates tracked since 2022).

On this page

About Amanda Rascon NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AMANDA RASCON (NPI 1063157253) is an individual family provider in Glendale, Arizona, licensed in Arizona (274285) and active in the NPI registry since May 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1063157253

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameAMANDA RASCON

Location Address11851 N 51ST AVE STE B110Glendale, AZ 85304-2823

Mailing Address7500 N Dreamy Draw Dr Ste 145Phoenix, AZ 85020-4668 · (480) 882-4545

Phone(480) 882-4545

Fax(623) 207-7410

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateMay 2, 2022

Last NPPES UpdateOctober 13, 20252 updates tracked since enumeration

NPPES CertifiedOctober 13, 2025

✔ NPI 1063157253 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in AZ · 274285

11851 N 51ST AVE STE B110, Glendale, AZ 85304

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health, Blue Cross Blue Shield of Arizona and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Amanda Rascon is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5799163697

PECOS Enrollment IDI20220606001706

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Amanda Rascon reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Neighborhood Outreach Access To Health

Same address

Federally Qualified Health Center (FQHC)

11851 N 51ST AVE STE B110
Glendale, AZ 85304

Reassigned Medicare billing, Arizona enrollment
119 clinicians in this Medicare group

NPI 1629515218 (480) 882-4545

Good Health Medical, PLLC

1.8 mi

Family Medicine

5102 W OLIVE AVE STE 101
Glendale, AZ 85302

Reassigned Medicare billing, Arizona enrollment
321 clinicians in this Medicare group

NPI 1700664729 (480) 677-8282

Clinica La Familia, PC

9.0 mi

Internal Medicine

13402 N 32ND ST
Phoenix, AZ 85032

Reassigned Medicare billing, Arizona enrollment
32 clinicians in this Medicare group

NPI 1780668921 (602) 569-3999

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85304 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.89 typical visit price

range $55.44 – $168.60

Typical copayment $21.47 (range $13.86 – $42.15)

Most-billed visit code 99203

Established Patient

$98.00 typical visit price

range $17.72 – $137.41

Typical copayment $24.50 (range $4.43 – $34.35)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JEFFREY S JIRAK LPC, LISAC

Counselor (Mental Health)