Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mara Danielle Immediato, PA-C

Individual provider Surgical Physician Assistant · NPI 1538410071

Mara Danielle Immediato, PA-C is a Physician Assistant in Tempe, Arizona. Qualified in 2012, 14 years ago. Practices with Select Physical Therapy Holdings Inc, a 2,121-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
14
Licensed in
AZ
In the registry since
2012
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1255 W Rio Salado Pkwy Ste 107
Tempe, AZ 85281-2892
Phone: (480) 962-0071
Fax: (480) 962-0590
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 5195 (AZ)

Record details

NPI number1538410071
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 24, 2012
Last updated in NPPESFebruary 4, 2019

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Select Physical Therapy Holdings Inc — 2121 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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