Organization
Sportsmedicine Outreach Specialist
Provider's NPPES record last updated: March 17, 2026
Overview
- Entity Type
- Organization
- NPI
- 1053898833
- Primary Specialty
- Physician Assistant — Surgical
- Practice Location
- Gilbert, Arizona
- Organization Subpart
- No
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 19, 2026, 11:41 AM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Physician Assistant
Surgical
Physician Assistants & Advanced Practice Nursing Providers
Definition to come...
Taxonomy code 363AS0400X
Provider-Reported License Information
- Physician Assistant (Arizona)
- 3233
Practice Locations
Practice Location
835 W Warner Rd
Ste 101-448
Gilbert, Arizona 85233-7269
Phone: (602) 689-9588
Additional Practice Location
9003 E Shea Blvd
Scottsdale, Arizona 85260-6709
Phone: (480) 980-8206
Fax: (480) 281-5224
Additional Practice Location
8405 N. Pima Center Parkway
Scottsdale, Arizona 85258-4474
Phone: (480) 980-8206
Fax: (480) 281-5224
Additional Practice Location
1446 W Redondo Dr
Gilbert, Arizona 85233-0910
Phone: (602) 689-9588
Fax: (480) 281-5224
Additional Practice Location
8901 E. Raintree Drive
Suite 100
Scottsdale, Arizona 85260-7026
Phone: (480) 980-8206
Fax: (480) 281-5224
Record Information
- Enumeration Date
- July 24, 2018
- Provider's NPPES Record Last Updated
- March 17, 2026
- Certification Date
- March 17, 2026
- NPISignal NPPES Dataset
- August 2026
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