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

Mario Lant, PA-C

Individual provider Physician Assistant · NPI 1811651193

Mario Lant, PA-C is a Physician Assistant in Glendale, Arizona. Graduated from At Still Un of Hlth Sciences, Col of Osteo Med, Mesa in 2022, 4 years ago. Practices with Banner Physician Specialists Arizona LLC, a 372-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Arizona.

Years since qualifying
4
Trained at
At Still Un of Hlth Sciences, Col of Osteo Med, Mesa
Licensed in
AZ
In the registry since
2021
Specialties on file
2
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

18700 N 64th Dr Ste 301
Glendale, AZ 85308-7114
Phone: (623) 748-0145
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 485 S Dobson Rd Ste 110, Chandler, AZ 85224-5600 — (480) 728-4470

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 9455 (AZ)

Record details

NPI number1811651193
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 24, 2021
Last updated in NPPESMarch 14, 2025
Certification dateMarch 14, 2025

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 2022 (4 years in practice)
Group practice Banner Physician Specialists Arizona Llc — 372 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

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