Look up the most recent NPI and PECOS records

Rose Marie Mintz

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

PECOS Enrollment

This provider is enrolled in PECOS as ROSE MINTZ.

Based on the most recent information from CMS, provider Rose Marie Mintz is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1639560816
Provider Type
Individual
Full Name
Mintz, Rose Marie
Credential
PA-C

Gender
Female
Sole Proprietor
Yes
Enumeration Date
2/10/2015
Last Updated
5/16/2023

Contact Information

Practice Location

9015 N 3rd St, Phoenix, AZ 85020-2444

(480) 882-4545

(602) 714-3755

Mailing Location

312 N Alma School Rd Ste 11, Chandler, AZ 85224-4354

(623) 300-5477

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 5991 Arizona
Code 363AM0700X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License Unlisted Issuer

Provider Identifiers

ID	Description	Issuer
ID 467439	Description Medicaid	Issuer Unlisted Arizona

Rose Marie Mintz

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

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