Minkeale Tedla, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

14419 W McDowell Rd
Goodyear, AZ 85395-2511

Phone

(623) 248-1950

NPI assigned

Apr 9, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1033672753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14419 W MCDOWELL RD",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952511",
            "telephone_number": "623-248-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14419 W MCDOWELL RD",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952511",
            "telephone_number": "623-248-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEDLA",
        "first_name": "MINKEALE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-09",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie L Taylor, OTR/L
• Lindsay Taylor, MD
• Teamnp PLLC
• Peter Tamunoh Teboh, FNP-BC
• Agelina Techago
• Shirley Lorraine Temple, MSN-FNP
• Kurt James Tengberg, PA
• Melinda Tenorio, P.T.
• Terracotta Behavioral Health, PLLC
• The Family House Behavioral Services LLC

• Physician Assistant in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.