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FLAGSTAFF SURGICAL ASSOCIATES PA
NPI 1114995271
Surgery - Surgical Critical Care in Flagstaff, AZ

Active since March 14, 2006CLIA 03D1103484 · Waiver
77 W FOREST AVE STE 201, FLAGSTAFF, AZ 86001(928) 773-2222(928) 773-2598 Get Directions Write a Review

NPPES record last updated: October 24, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 6, 2020, Nov 16, 2018 (2 updates tracked since 2018).

About Flagstaff Surgical Associates Pa NPPES

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

FLAGSTAFF SURGICAL ASSOCIATES PA (NPI 1114995271) is a healthcare organization registered as a surgical critical care in Flagstaff, Arizona and active in the NPI registry since March 2006. The organization holds a CLIA Waiver certificate valid through November 30, 2026, maintains a secondary practice location in Flagstaff, and lists Daniel Lee Wilson, Manager, as its authorized official.

NPPES Registry Identity

NPI1114995271
Entity TypeOrganization
Primary Taxonomy2086S0102X
Legal Business NameFLAGSTAFF SURGICAL ASSOCIATES PA
Location Address77 W FOREST AVE STE 201Flagstaff, AZ 86001-1483
Mailing Address77 W Forest Ave Ste 201Flagstaff, AZ 86001-1483 · (928) 773-2222 · Fax (928) 773-2598
Phone(928) 773-2222
Fax(928) 773-2598
Organization SubpartNo
Authorized OfficialDaniel Lee WilsonManager · (928) 773-2572
Enumeration DateMarch 14, 2006
Last NPPES UpdateOctober 24, 20252 updates tracked since enumeration
NPPES CertifiedOctober 24, 2025
✔ NPI 1114995271 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Surgical Critical CareAllopathic & Osteopathic Physicians
Taxonomy Code2086S0102X
Definition
A surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.
77 W FOREST AVE STE 201, Flagstaff, AZ 86001
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Secondary Practice Location 1

Location 177 W Forest Ave Ste 212Flagstaff, AZ 86001-1481 · Phone (928) 773-2222 ext. 5 · Fax (928) 773-2598

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health, Cigna HealthCare of Arizona, Inc and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Flagstaff Surgical Associates Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

36

Medicare enrollment records show 36 clinicians reassign Medicare billing to Flagstaff Surgical Associates PA, which bills Medicare for the services they deliver. Of these, 17 practice at this address and 24 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 9

General Surgery16
Nurse Practitioner5
Qualified Audiologist5
Urology4
Otolaryngology2
Critical Care (Intensivists)1
Emergency Medicine1
Gastroenterology1
1 other specialty1

Nearest to this location (20)

See all 36
Andrew Aldridge, MD
General Surgery
NPI 1497724017
77 W FOREST AVE STE 201
Flagstaff, AZ 86001
(928) 773-2222
✔ PECOS✔ Accepts MedicareSame address
William Badger, M.D.
Urology
NPI 1003935479
77 W FOREST AVE STE 201
Flagstaff, AZ 86001
(928) 773-2222
✔ PECOS✔ Accepts MedicareSame address
Kerry Beasley, AU.D
Qualified Audiologist
NPI 1053853945
77 W FOREST AVE STE 212
Flagstaff, AZ 86001
(928) 773-2222
✔ Accepts MedicareSame address
Robert Berger, M.D.
General Surgery
NPI 1417926874
77 W FOREST AVE STE 201
Flagstaff, AZ 86001
(928) 773-2222
✔ PECOS✔ Accepts MedicareSame address
Kathleen Collins, DO, MBA
General Surgery
NPI 1942737978
77 W FOREST AVE STE 201
Flagstaff, AZ 86001
(928) 773-2222
✔ PECOS✔ Accepts MedicareSame address
Joshua Damian, M.D.
Emergency Medicine
NPI 1689085821
77 W FOREST AVE STE 201
Flagstaff, AZ 86001
(928) 773-2222
✔ PECOS✔ Accepts MedicareSame address
Christopher Gomez, APRN
Nurse Practitioner
NPI 1871215723
77 W FOREST AVE STE 201
Flagstaff, AZ 86001
(928) 773-2222
✔ PECOS✔ Accepts MedicareSame address
Ralph Kelley, DO
General Surgery
NPI 1538369384
77 W FOREST AVE STE 206
Flagstaff, AZ 86001
(239) 980-4302
✔ PECOS✔ Accepts MedicareSame address
Rachel Lindquist, APRN FNP-C
Nurse Practitioner
NPI 1790463370
77 W FOREST AVE STE 201
Flagstaff, AZ 86001
(928) 773-2222
✔ PECOS✔ Accepts MedicareSame address
Alexander Lund, D.O.
Otolaryngology
NPI 1376819417
77 W FOREST AVE STE 107
Flagstaff, AZ 86001
(928) 773-2222
✔ PECOS✔ Accepts MedicareSame address
Kate Preston, M.D.
General Surgery
NPI 1265692982
77 W FOREST AVE STE 201
Flagstaff, AZ 86001
(928) 773-2222
✔ PECOS✔ Accepts MedicareSame address
Jon Rumohr, MD
Urology
NPI 1891842761
77 W FOREST AVE STE 201
Flagstaff, AZ 86001
(928) 773-2222
✔ PECOSSame address
Sarah Sohail, MD
General Surgery
NPI 1326537507
77 W FOREST AVE STE 201
Flagstaff, AZ 86001
(928) 773-2222
✔ PECOS✔ Accepts MedicareSame address
John Stupinski, MD
General Surgery
NPI 1376070953
77 W FOREST AVE STE 201
Flagstaff, AZ 86001
(928) 773-2222
✔ PECOS✔ Accepts MedicareSame address
Michael Trujillo, M.D.
Gastroenterology
NPI 1467417824
77 W FOREST AVE STE 210
Flagstaff, AZ 86001
(928) 773-2547
✔ PECOSSame address
Bradford Willox, MD
General Surgery
NPI 1760943872
77 W FOREST AVE STE 201
Flagstaff, AZ 86001
(928) 773-2222
✔ PECOS✔ Accepts MedicareSame address
Rodney Engel, M.D.
Internal Medicine
NPI 1659351187
77 W FOREST AVE SUITE 210
Flagstaff, AZ 86001
(928) 773-2547
✔ PECOS✔ Accepts MedicareSame address
Kylie Dickman, MD
General Surgery
NPI 1881223063
77 W FOREST AVE STE 201
Flagstaff, AZ 86001
(928) 773-2222
✔ PECOS0.1 mi
Amanda Mattei, AU.D.
Qualified Audiologist
NPI 1881520534
77 W FOREST AVE STE 305
Flagstaff, AZ 86001
(928) 773-2222
0.1 mi
Tamarah Fratianni, D.O
Otolaryngology
NPI 1689673972
1340 N RIM DR
Flagstaff, AZ 86001
(928) 774-1873
✔ PECOS✔ Accepts Medicare0.2 mi
See all 36 clinicians

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D1103484

Flagstaff Surgical Associates · Flagstaff, AZ
Active · expires Nov 30, 2026
CLIA Number03D1103484
Laboratory TypePhysician Office
Certificate Effective DateDecember 1, 2024
Certificate Expiration DateNovember 30, 2026
Laboratory DirectorWilliam Badger
Laboratory Phone(928) 773-2222
Laboratory LocationFlagstaff Surgical Associates77 W Forest Ave Suite 201, Flagstaff, AZ 86001
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Flagstaff Surgical Associates PA's NPI number?

The NPI number for Flagstaff Surgical Associates PA is 1114995271. It was assigned to this organization in the NPPES registry on March 14, 2006.

Where is Flagstaff Surgical Associates PA located?

Flagstaff Surgical Associates PA is located at 77 W Forest Ave Ste 201, Flagstaff, AZ 86001. The listed phone number is (928) 773-2222.

What is Flagstaff Surgical Associates PA's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Surgical Critical Care, with taxonomy code 2086S0102X.

Is Flagstaff Surgical Associates PA enrolled in Medicare?

Yes. Flagstaff Surgical Associates PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Flagstaff Surgical Associates PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 36 clinicians in 9 Medicare specialties reassign their Medicare billing to Flagstaff Surgical Associates PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are General Surgery (16), Nurse Practitioner (5) and Qualified Audiologist (5). Of these, 17 practice at this address and 24 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Flagstaff Surgical Associates PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D1103484) is associated with this NPI, valid through November 30, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Flagstaff Surgical Associates PA accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Cigna HealthCare of Arizona, Inc and Imperial Insurance Companies, Inc. list Flagstaff Surgical Associates PA 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 Flagstaff Surgical Associates PA was last updated on October 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.