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

Tara Nicole Brzezinski

Individual provider Physician Assistant · NPI 1124732623

Tara Nicole Brzezinski is a Physician Assistant in Flagstaff, Arizona. Qualified in 2022, 4 years ago. Practices with Genesis OB GYN PLLC, a 108-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
4
Licensed in
AZ
In the registry since
2023
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1100 N San Francisco St Ste B
Flagstaff, AZ 86001-3260
Phone: (928) 779-7851
Fax: (928) 213-9990
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 10615 (AZ)

Record details

NPI number1124732623
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJanuary 9, 2023
Last updated in NPPESJuly 14, 2026
Certification dateJuly 14, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Genesis Ob Gyn Pllc — 108 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Flagstaff