WANDA G ICHIRIU PA
NPI 1366569246
Physician Assistant in Mesa, AZ

Q: What is Wanda Ichiriu's NPI number?

The NPI number for Wanda Ichiriu is 1366569246. It was assigned to this individual provider in the NPPES registry on March 23, 2007.

Q: What is Wanda Ichiriu's specialty?

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

Q: Is Wanda Ichiriu enrolled in Medicare?

No. Wanda Ichiriu has opted out of Medicare through October 1, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Wanda Ichiriu was last updated on November 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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 March 23, 2007Opted out of Medicare · through Oct 1, 2026

4135 S POWER RD STE 113, MESA, AZ 85212(480) 626-2444(480) 409-2987 Get Directions Write a Review

NPPES record last updated: November 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 21, 2022, Oct 7, 2021, Sep 24, 2021 (3 updates tracked since 2021).

On this page

About Wanda G Ichiriu Pa NPPES

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

WANDA G ICHIRIU PA (NPI 1366569246) is an individual physician assistant in Mesa, Arizona, licensed in Arizona (8561) and active in the NPI registry since March 2007. She has opted out of Medicare through October 1, 2026 and remains eligible to order and refer and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1366569246

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameWANDA G ICHIRIUCredential: PA

Location Address4135 S POWER RD STE 113Mesa, AZ 85212-3625

Mailing AddressPo Box 88747Milwaukee, WI 53288-5499 · (480) 945-6777 · Fax (480) 481-5070

Phone(480) 626-2444

Fax(480) 409-2987

Sole ProprietorNo

Enumeration DateMarch 23, 2007

Last NPPES UpdateNovember 21, 20223 updates tracked since enumeration

NPPES CertifiedNovember 21, 2022

✔ NPI 1366569246 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in AZ · 8561

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.

4135 S POWER RD STE 113, Mesa, AZ 85212

Open in Google Maps ↗

Secondary Practice Locations 2

Location 113400 E Shea BlvdScottsdale, AZ 85259-5499 · Phone (480) 301-8000 · Fax (480) 342-5854

Location 26900 E Camelback Rd Ste 850Scottsdale, AZ 85251-2443 · Phone (602) 539-5495 · Fax (480) 481-5070

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona, Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Wanda G Ichiriu Pa has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2024 through October 1, 2026.

Opt-Out Effective DateOctober 1, 2024

Opt-Out In Effect ThroughOctober 1, 2026Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

20 services19 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85212 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 6

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

JASMYN ALANA-JERRI BUCHANAN PA-C

Physician Assistant