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

Individual provider Physician Assistant · NPI 1992708523

Mark A Thiele, PA-C is a Physician Assistant in Prescott, Arizona. Qualified in 2004, 22 years ago. Practices with Granite Orthopaedics PLLC, a 12-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
22
Licensed in
AZ
In the registry since
2005
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

1223 Willow Creek Rd
Prescott, AZ 86301-1427
Phone: (928) 777-9950
Fax: (928) 777-9975
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 4659 (AZ)

Record details

NPI number1992708523
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 27, 2005
Last updated in NPPESMarch 29, 2017
Mailing address1223 Willow Creek Rd, Prescott, AZ 86301-1427

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Granite Orthopaedics Pllc — 12 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Prescott