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

Nidal Abukhalil, PA-S

Individual provider Physician Assistant · NPI 1104667757

Nidal Abukhalil, PA-S is a Physician Assistant in Mesa, Arizona. Qualified in 2025, 1 year ago. Practices with Desert Bolt Behavioral LLC, a 4-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
1
Licensed in
AZ
In the registry since
2024

Practice location Address checks out

5850 E Still Cir
Mesa, AZ 85206-3618
Phone: (480) 219-6000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 11473 (AZ)

Record details

NPI number1104667757
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-S
Sole proprietorNo
NPI enumeratedJune 5, 2024
Last updated in NPPESMarch 25, 2026
Certification dateMarch 25, 2026
Mailing address5850 E Still Cir, Mesa, AZ 85206-3618

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Desert Bolt Behavioral Llc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Mesa