DAELUN JACOB MCRAE PA-C NPI 1215609144

NPI Information

  • NPI: 1215609144
  • Provider Name: DAELUN JACOB MCRAE, PA-C
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 5564 S KEENE
    MESA, AZ
    ZIP 85212
  • Phone: (928) 651-2960

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NPI Details

Daelun Jacob Mcrae, PA-C is a medical physician assistant in Mesa, AZ. Daelun Jacob Mcrae, PA-C NPI is 1215609144. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5564 S KEENE
MESA, AZ
ZIP 85212-130
Phone: (928) 651-2960

The NPI 1215609144 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/29/2021 and was last updated on 12/15/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363A00000XPhysician AssistantNo
2363AM0700XPhysician AssistantMedicalNo
3363AM0700XPhysician AssistantMedical8817ARIZONAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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