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PHYSICIAN ASSISTANT - SURGICAL ASSIST, LLC
NPI 1942579750
Physician Assistant - Surgical in Chandler, AZ

Active since December 22, 2011
4980 S ALMA SCHOOL RD, A2-130, CHANDLER, AZ 85248(480) 215-3035 Get Directions Write a Review

NPPES record last updated: December 22, 2011. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Physician Assistant - Surgical Assist, Llc NPPES

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

PHYSICIAN ASSISTANT - SURGICAL ASSIST, LLC (NPI 1942579750) is a healthcare organization registered as a surgical in Chandler, Arizona and active in the NPI registry since December 2011. The organization lists Nicole Vincelette, Physician Assistant, as its authorized official.

NPPES Registry Identity

NPI1942579750
Entity TypeOrganization
Primary Taxonomy363AS0400X
Legal Business NamePHYSICIAN ASSISTANT - SURGICAL ASSIST, LLC
Location Address4980 S ALMA SCHOOL RD, A2-130Chandler, AZ 85248-5545
Mailing Address4980 S Alma School Rd, A2-130Chandler, AZ 85248-5545
Phone(480) 215-3035
Organization SubpartNo
Authorized OfficialNicole VincelettePhysician Assistant · (480) 215-3035
Enumeration DateDecember 22, 2011
✔ NPI 1942579750 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in AZ · 2841
4980 S ALMA SCHOOL RD, Chandler, AZ 85248
Open in Google Maps ↗

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 revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Physician Assistant - Surgical Assist, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateArizonaEnrollment IDO20120227000270Non-DME Part B · Clinic/Group PracticeDue dateDecember 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Other Providers at the Same Location NPPES 4

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

EAST VALLEY MEDICINE PLC
Hospitalist
4980 S ALMA SCHOOL RD, SUITE A2 #194
CHANDLER, AZ 85248
Maricopa County (480) 883-1042
MRS. NICOLE ELIZABETH VINCELETTE PA
Physician Assistant
4980 S ALMA SCHOOL RD, SUITE A2-130
CHANDLER, AZ 85248
Maricopa County (480) 215-3035
STRATEGIES FOR SUCCESS CONSULTING, PC
Nurse Practitioner (Family)
4980 S ALMA SCHOOL RD, SUITE A-242
CHANDLER, AZ 85248
Maricopa County (480) 252-5152
CIGNA HEALTHCARE OF ARIZONA, INC.
Clinic/Center
4980 S ALMA SCHOOL RD, STE. A-3
CHANDLER, AZ 85248
Maricopa County (480) 895-8955

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 Physician Assistant - Surgical Assist, LLC's NPI number?

The NPI number for Physician Assistant - Surgical Assist, LLC is 1942579750. It was assigned to this organization in the NPPES registry on December 22, 2011.

Where is Physician Assistant - Surgical Assist, LLC located?

Physician Assistant - Surgical Assist, LLC is located at 4980 S Alma School Rd A2-130, Chandler, AZ 85248. The listed phone number is (480) 215-3035.

What is Physician Assistant - Surgical Assist, LLC's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Physician Assistant - Surgical Assist, LLC enrolled in Medicare?

Yes. Physician Assistant - Surgical Assist, LLC is registered in the Medicare PECOS enrollment system.

When is Physician Assistant - Surgical Assist, LLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Arizona, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

When was this NPI record last updated?

The NPPES record for Physician Assistant - Surgical Assist, LLC was last updated on December 22, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.