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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SADIE JO BOUWENS
NPI 1508615394
Physician Assistant in Dewey, AZ

Active since May 15, 2024PECOS Enrolled
12075 E STATE ROUTE 69 STE B, DEWEY, AZ 86327(928) 772-1673(928) 772-1674 Get Directions Write a Review

NPPES record last updated: October 22, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 1, 2026, Aug 27, 2026, May 15, 2024 (3 updates tracked since 2024).

About Sadie Jo Bouwens NPPES

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

SADIE JO BOUWENS (NPI 1508615394) is an individual physician assistant in Dewey, Arizona, licensed in Arizona (12071) and active in the NPI registry since May 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1508615394
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameSADIE JO BOUWENS
Location Address12075 E STATE ROUTE 69 STE BDewey, AZ 86327-4569
Mailing Address12075 E State Route 69 Ste BDewey, AZ 86327-4569 · (928) 772-1673 · Fax (928) 772-1674
Phone(928) 772-1673
Fax(928) 772-1674
Sole ProprietorNo
Enumeration DateMay 15, 2024
Last NPPES UpdateOctober 22, 20263 updates tracked since enumeration
NPPES CertifiedOctober 22, 2026
✔ NPI 1508615394 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 · 12071
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.
12075 E STATE ROUTE 69 STE B, Dewey, AZ 86327
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sadie Jo Bouwens is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 86327 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 8

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

MS. LINDA JO NELSON FNP
Nurse Practitioner (Family)
12075 E STATE ROUTE 69 STE B
PRESCOTT VALLEY, AZ 86327
Yavapai County (928) 772-1673
TATYANA ERDMANN P.A.
Physician Assistant
12075 E STATE ROUTE 69 STE B
DEWEY, AZ 86327
Yavapai County (928) 772-1673
LINDSEY M ROBBINS FNP-C
Nurse Practitioner (Family)
12075 E STATE ROUTE 69 STE B
DEWEY, AZ 86327
Yavapai County (928) 772-1673
MIRYAM ROSE KNIGGE PA
Physician Assistant
12075 E STATE ROUTE 69 STE B
DEWEY, AZ 86327
Yavapai County (928) 772-1673
AUSTIN JOHN HARMON PA-C
Physician Assistant
12075 E STATE ROUTE 69 STE B
DEWEY, AZ 86327
Yavapai County (928) 772-1673
ALYSSA WAHLSTROM PA-C
Physician Assistant
12075 E STATE ROUTE 69 STE B
DEWEY, AZ 86327
Yavapai County (928) 772-1673
ASURA HEALTHCARE LLC
Family Medicine
12075 E STATE ROUTE 69 STE B
DEWEY, AZ 86327
Yavapai County (405) 590-8861
TANNER DAVIS DNP
Nurse Practitioner (Family)
12075 E STATE ROUTE 69 STE B
DEWEY, AZ 86327
Yavapai County (928) 772-1673

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 Sadie Bouwens's NPI number?

The NPI number for Sadie Bouwens is 1508615394. It was assigned to this individual provider in the NPPES registry on May 15, 2024.

Where is Sadie Bouwens located?

Sadie Bouwens practices at 12075 E State Route 69 Ste B, Dewey, AZ 86327. The listed phone number is (928) 772-1673.

What is Sadie Bouwens's specialty?

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

Is Sadie Bouwens enrolled in Medicare?

Yes. Sadie Bouwens is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Sadie Bouwens was last updated on October 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 days 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.