Individual provider Active NPI

Elizabeth Calvillo, PA-C

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1053188037
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10696 Issued in AZ
Practice address
8141 W Camelback Rd # B-101
Phoenix, AZ 85033-1050
Phone
(480) 677-8282
Fax
(888) 316-1686
NPI assigned
Dec 8, 2023
Last updated
Sep 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10696 AZ Primary

Addresses

Primary practice location

8141 W Camelback Rd # B-101
Phoenix, AZ 85033-1050

Mailing address

261 N Roosevelt Ave
Chandler, AZ 85226-2617
Phone (480) 305-2888

Other identifiers 1

IdentifierTypeStateIssuer
171518MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251001003476 AZ Practitioner - Physician Assistant 3678079373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Good Health Medical PLLCGroup PAC ID 3779680962, 215 clinicians

Practice addresses (Care Compare)

10613 W Olive Ave
Suite 200
Peoria, AZ 85345-7339
Phone (480) 677-8282

17063 W Greenway Rd
Suite 102
Surprise, AZ 85388-9605
Phone (480) 677-8282

2632 S 83Rd Ave
Suite 113
Phoenix, AZ 85043-7206
Phone (480) 677-8282

428 S Gilbert Rd
Suite 101
Gilbert, AZ 85296-2261
Phone (480) 677-8282

7448 W Glendale Ave
Suite C 140
Glendale, AZ 85303-2575
Phone (480) 677-8282

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Good Health Medical, PLLC CurrentSince Sep 22, 2025 Accepting new patients
Good Health Medical, PLLC CurrentSince Sep 22, 2025 Accepting new patients
Good Health Medical, PLLC Past Accepting new patients
Desert Kidney Associates PLC Past Accepting new patients
Livn, P.C. Past Accepting new patients
Clinica la Familia, PC PastSince Aug 1, 2003 Accepting new patients

Locations

261 N Roosevelt Ave
Chandler, AZ 85226
Phone (480) 305-2888

428 S Gilbert Rd
Ste 101
Gilbert, AZ 85296
Phone (480) 632-7400

11320 W Tangerine Rd
Ste 101
Marana, AZ 85653
Phone (880) 677-8282

8141 W Camelback Rd
Ste B101
Phoenix, AZ 85033

287 E Hunt Hwy
Ste 105
San Tan Valley, AZ 85143
Phone (480) 667-8282

Interoperability endpoints

  • FHIR API: https://epicproxy.et4001.epichosted.com/APIProxyPRD/MDN/api/FHIR/R4

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1701993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758240000000",
    "number": "1053188037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 N ROOSEVELT AVE",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852262617",
            "telephone_number": "480-305-2888",
            "fax_number": "844-470-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8141 W CAMELBACK RD # B-101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850331050",
            "telephone_number": "480-677-8282",
            "fax_number": "888-316-1686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALVILLO",
        "first_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-08",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "10696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171518",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.