Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1366569246 Individual Practitioner Female Practitioner

Wanda G Ichiriu , PA

Physician Assistant • Mesa, AZ

Professional Overview & Biography Verified Profile Summary

Wanda Ichiriu, PA is a registered healthcare professional specializing in Physician Assistant in Mesa, AZ. Practice services are available at 4135 S POWER RD STE 113 under active NPI credentials.

Frequently performed procedures and clinical services include established patient outpatient office visit, prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service;, injection, darbepoetin alfa, 1 microgram (non-esrd use). Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

4135 S Power Rd Ste 113

Mesa, AZ 852123625

Telephone 4806262444
Fax 4804092987
Associated Practice Facility / Clinic
🏢 Forte - Phoenix, Pllc Facility NPI 1255860342

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Mesa, AZ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 7.6 Yrs
State Avg: 12.5 Yrs
Regional Practice Density
474 Specialists

Practicing in Mesa, AZ (3711 Statewide)

Telehealth Adoption Rate
8.2% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
65.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
20 19 $300.00 $104.70

Medical Specialties & State Licenses

CMS Verified: 2022-11-21
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License AZ 8561

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Secondary Practice Locations

13400 E Shea Blvd

Scottsdale, AZ 852595499

Phone: 4803018000

6900 E Camelback Rd Ste 850

Scottsdale, AZ 852512443

Phone: 6025395495

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

10 Associated Practitioners
Anita Gregory , PT

Physical Therapist

NPI 1013080555

Physical Therapist

Abigail Brinkman , OTR, L

Occupational Therapist

NPI 1093341182

Occupational Therapist Registered, L

Jasmyn Buchanan , PA-C

Physician Assistant

NPI 1124684097

Physician Assistant (Certified)

Dory Grobeck , PA-C

Physician Assistant - Medical

NPI 1144906330

Physician Assistant (Certified)

Chantelle Iloreta , PA-C

Physician Assistant - Medical

NPI 1225745029

Physician Assistant (Certified)

Lauren Mcwilliams , PA-C

Physician Assistant

NPI 1417848953

Physician Assistant (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
📍
Updated Practice Location November 21, 2022

Registered at 4135 S POWER RD STE 113, MESA, AZ 852123625 (Tel: 4806262444)

📍
Updated Business Mailing Address November 21, 2022

Registered at PO BOX 88747, MILWAUKEE, WI 532885499 (Tel: 4809456777)

📍
Updated Practice Location October 07, 2021

Registered at 13400 E SHEA BLVD, SCOTTSDALE, AZ 852595499 (Tel: 4803018000)

📍
Updated Business Mailing Address October 07, 2021

Registered at 13400 E SHEA BLVD, SCOTTSDALE, AZ 852595499 (Tel: 4803018000)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 07, 2021

Physician Assistant (License #8561 in AZ)

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 1400 S GRAND AVE STE 800, LOS ANGELES, CA 900153048 (Tel: 2137481414)

📍
Updated Business Mailing Address July 08, 2007

Registered at 1400 S GRAND AVE STE 800, LOS ANGELES, CA 900153048 (Tel: 2137481414)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as WANDA ICHIRIU, PA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Physician Assistant (License #PA13938 in CA)

🟢
Initial NPI Registration & Enumeration March 23, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Wanda Ichiriu. Be the first to share your experience!

Sign in to leave a review for Wanda Ichiriu

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1366569246
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 23, 2007
Last Update: November 21, 2022
Sole Proprietor: No

Mailing Address

Po Box 88747

Milwaukee, WI 532885499

Phone: 4809456777

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.