NORTHERN ARIZONA SURGICAL ASSISTING LLC
NPI 1568086437
Nurse Practitioner in Flagstaff, AZ

Q: What is Northern Arizona Surgical Assisting LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Active since June 05, 2020

4209 W INDIGO WAY, FLAGSTAFF, AZ 86001(760) 731-0313(951) 587-8277 Get Directions Write a Review

NPPES record last updated: April 16, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 15, 2023, Jun 5, 2020 (2 updates tracked since 2020).

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About Northern Arizona Surgical Assisting Llc NPPES

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

NORTHERN ARIZONA SURGICAL ASSISTING LLC (NPI 1568086437) is a healthcare organization registered as a nurse practitioner in Flagstaff, Arizona and active in the NPI registry since June 2020. The organization lists Jessica A Diefenbach, Owner, as its authorized official.

NPPES Registry Identity

NPI1568086437

Entity TypeOrganization

Primary Taxonomy363L00000X

Legal Business NameNORTHERN ARIZONA SURGICAL ASSISTING LLC

Location Address4209 W INDIGO WAYFlagstaff, AZ 86001-8228

Mailing Address4209 W Indigo WayFlagstaff, AZ 86001-8228 · (214) 227-2457 · Fax (214) 764-0880

Phone(760) 731-0313

Fax(951) 587-8277

Organization SubpartNo

Authorized OfficialJessica A DiefenbachOwner · (214) 227-2457

Enumeration DateJune 5, 2020

Last NPPES UpdateApril 16, 20252 updates tracked since enumeration

NPPES CertifiedApril 16, 2025

✔ NPI 1568086437 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

4209 W INDIGO WAY, Flagstaff, AZ 86001

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Northern Arizona Surgical Assisting Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Northern Arizona Surgical Assisting LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jessica Diefenbach, NP

Nurse Practitioner

NPI 1861016735

PO BOX 50003
Sparks, NV 89435

(214) 227-2457

✔ PECOS✔ Accepts Medicare531 mi

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

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 Northern Arizona Surgical Assisting LLC's NPI number?

The NPI number for Northern Arizona Surgical Assisting LLC is 1568086437. It was assigned to this organization in the NPPES registry on June 5, 2020.

Where is Northern Arizona Surgical Assisting LLC located?

Northern Arizona Surgical Assisting LLC is located at 4209 W Indigo Way, Flagstaff, AZ 86001. The listed phone number is (760) 731-0313.

What is Northern Arizona Surgical Assisting LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Northern Arizona Surgical Assisting LLC enrolled in Medicare?

Yes. Northern Arizona Surgical Assisting LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Northern Arizona Surgical Assisting LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Northern Arizona Surgical Assisting LLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Northern Arizona Surgical Assisting LLC was last updated on April 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.