Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mai Frederick

Individual provider Physician Assistant · NPI 1477118180

Mai Frederick is a Physician Assistant in Mesa, Arizona. Graduated from At Still Un of Hlth Sciences, Col of Osteo Med, Mesa in 2020, 6 years ago. Practices with Denova Collaborative Health, LLC, a 143-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Arizona.

Years since qualifying
6
Trained at
At Still Un of Hlth Sciences, Col of Osteo Med, Mesa
Licensed in
AZ
In the registry since
2019
Specialties on file
3
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Practice location Address checks out

2120 W Guadalupe Rd Ste 7 8 9
Mesa, AZ 85202-6457
Phone: (602) 230-7373
Fax: (480) 629-8577
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3033 N Central Ave Ste 700, Phoenix, AZ 85012-2806 — (602) 230-7373

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA-8041 (AZ)
Physician Assistant Taxonomy 363A00000X · Licence 8041 (AZ)
Psychiatric/Mental Health Clinical Nurse Specialist Taxonomy 364SP0808X · Licence 8041 (AZ)

Record details

NPI number1477118180
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 8, 2019
Last updated in NPPESApril 7, 2025
Certification dateApril 7, 2025
Mailing address3101 N Central Ave Ste 550, Phoenix, AZ 85012-2635

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolAT STILL UN OF HLTH SCIENCES, COL OF OSTEO MED, MESA
Graduated 2020 (6 years in practice)
Group practice Denova Collaborative Health, Llc — 143 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Mesa