Provider Provider PC
NPI 1760969190ActiveOrganization· General Practice· Mesa, AZ
General Practice in Mesa, Arizona, registered in NPPES in July 2018. The authorized official on file is Jonathan Harris, PHYSICIAN ASSISTANT, Pa-C/Member Of Corporation.
Overview
| NPI | 1760969190 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 28, 2018 |
| Last updated in NPPES | Dec 20, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| General Practice Primary | 208D00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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