Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Dominic Damian Freeburg, PA-C

Individual provider Surgical Physician Assistant · NPI 1407211808

Mr. Dominic Damian Freeburg, PA-C is a Physician Assistant in Mesa, Arizona. Qualified in 2017, 9 years ago. Practices with Banner Physician Specialists Arizona LLC, a 372-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
9
Licensed in
AZ
In the registry since
2015
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

6750 E Baywood Ave # 503
Mesa, AZ 85206-1749
Phone: (712) 389-2418
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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 6781 (AZ)

Record details

NPI number1407211808
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 29, 2015
Last updated in NPPESJune 14, 2024
Certification dateJune 14, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Banner Physician Specialists Arizona Llc — 372 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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