Individual provider Active NPI

Jeannesse Delgado, PA

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1043884778
Registry record updated May 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
704PA Issued in PR
Practice address
1201 S 7TH Ave
Phoenix, AZ 85007-3913
Phone
(407) 723-9788
NPI assigned
May 17, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 8515 AZ
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X 704PA PR Primary

Addresses

Primary practice location

1201 S 7TH Ave
Phoenix, AZ 85007-3913

Mailing address

55 E Ray Rd Ste 5-C
Chandler, AZ 85225-3337
Phone (407) 723-9788

Other practice location 1

55 E Ray Rd Ste 5-C
Chandler, AZ 85225-3337
Phone (407) 723-9788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
8515AZMDChiropractor
704PAPRMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746316800000",
    "number": "1043884778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 E RAY RD STE 5-C",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852253337",
            "telephone_number": "407-723-9788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S 7TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850073913",
            "telephone_number": "407-723-9788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 E Ray Rd Ste 5-C",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852253337",
            "country_code": "US",
            "telephone_number": "407-723-9788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELGADO",
        "first_name": "JEANNESSE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-17",
        "last_updated": "2025-05-04",
        "certification_date": "2025-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "8515",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "PR",
            "license": "704PA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2025; 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.