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SAN RABAN
NPI 1104693191
Physician Assistant in Gilbert, AZ

Active since December 08, 2023PECOS EnrolledAccepts Medicare Assignment
2946 E BANNER GATEWAY DR, GILBERT, AZ 85234(480) 256-6444(480) 256-4734 Get Directions Write a Review

NPPES record last updated: June 25, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 25, 2025, Dec 8, 2023 (2 updates tracked since 2023).

About San Raban NPPES

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

SAN RABAN (NPI 1104693191) is an individual physician assistant in Gilbert, Arizona and active in the NPI registry since December 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1104693191
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameSAN RABAN
Location Address2946 E BANNER GATEWAY DRGilbert, AZ 85234-2165
Mailing Address2946 E Banner Gateway DrGilbert, AZ 85234-2165 · (480) 256-6444 · Fax (480) 256-3682
Phone(480) 256-6444
Fax(480) 256-4734
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateDecember 8, 2023
Last NPPES UpdateJune 25, 20252 updates tracked since enumeration
NPPES CertifiedJune 25, 2025
✔ NPI 1104693191 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X
Also ListedPhysician Assistant · SurgicalTaxonomy 363AS0400X
2946 E BANNER GATEWAY DR, Gilbert, AZ 85234
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Oscar Health Plan, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

San Raban 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 ID749789428
PECOS Enrollment IDI20250819002950
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85234 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
$69.24 typical visit price
range $17.72 – $137.41
Typical copayment $17.31 (range $4.43 – $34.35)
Most-billed visit code 99213
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 20

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

SOYOUNG PARK MD
Internal Medicine (Hematology & Oncology)
2946 E BANNER GATEWAY DR
GILBERT, AZ 85234
Maricopa County (480) 256-6444
DR. AKSHAAR BRAHMBHATT MD
Radiology (Vascular & Interventional Radiology)
2946 E BANNER GATEWAY DR
GILBERT, AZ 85234
Maricopa County (480) 256-6444
THERESA ONG LIU DUMLAO MD
Internal Medicine (Hematology & Oncology)
2946 E BANNER GATEWAY DR, SUITE 450
GILBERT, AZ 85234
Maricopa County (480) 256-6444
DR. ZACHARY PHILLIP YEUNG MD
Internal Medicine (Medical Oncology)
2946 E BANNER GATEWAY DR
GILBERT, AZ 85234
Maricopa County (480) 245-6444
MICHAEL J POGGE AGACNP-BC
Nurse Practitioner (Acute Care)
2946 E BANNER GATEWAY DR
GILBERT, AZ 85234
Maricopa County (480) 256-6444
RICHARD D SUE MD
Internal Medicine (Pulmonary Disease)
2946 E BANNER GATEWAY DR
GILBERT, AZ 85234
Maricopa County (480) 256-6444
MRS. ALEXANDRIA NICOLE BARNES PA-C
Physician Assistant (Medical)
2946 E BANNER GATEWAY DR
GILBERT, AZ 85234
Maricopa County (480) 256-6444
ASHLEY JOHNSON KELLER PA-C
Physician Assistant
2946 E BANNER GATEWAY DR
GILBERT, AZ 85234
Maricopa County (480) 256-6444

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is San Raban's NPI number?

The NPI number for San Raban is 1104693191. It was assigned to this individual provider in the NPPES registry on December 8, 2023.

Where is San Raban located?

San Raban practices at 2946 E Banner Gateway Dr, Gilbert, AZ 85234. The listed phone number is (480) 256-6444.

What is San Raban's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is San Raban enrolled in Medicare?

Yes. San Raban is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does San Raban accept?

Health plans from Ambetter from Arizona Complete Health and Oscar Health Plan, Inc. list San Raban as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for San Raban was last updated on June 25, 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.