Individual provider Active NPI

Carlos Daniel Villalpando, PA-C

  • Physician Assistant
  • Sun City West, AZ
National Provider Identifier
1104485184
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10240 Issued in AZ
Practice address
14520 W Granite Valley Dr Ste 210
Sun City West, AZ 85375-5855
Phone
(866) 974-2673
Fax
(866) 939-2673
NPI assigned
Jun 12, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X ATR-001423 AZ
Physician Assistant 363A00000X 10240 AZ Primary

Addresses

Primary practice location

14520 W Granite Valley Dr Ste 210
Sun City West, AZ 85375-5855

Mailing address

18444 N 25TH Ave Ste 310
Phoenix, AZ 85023-1266
Phone (866) 974-2673

Other practice location 1

230 S 3rd St
Phoenix, AZ 85004-2697
Phone (602) 553-3113

Other identifiers 1

IdentifierTypeStateIssuer
206057MedicaidAZ

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
I20240605003339 AZ Practitioner - Physician Assistant 9335681337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Orthopedic Research and Education LLCGroup PAC ID 0345287322, 247 clinicians

Practice addresses (Care Compare)

10494 W Thunderbird Blvd
Sun City, AZ 85351-6122
Phone (866) 974-2673

Hospital & facility affiliations

  • The Core Institute Specialty Hosp Hospital, Phoenix, AZ, CCN 030108
  • Banner Estrella Medical Center Hospital, Phoenix, AZ, CCN 030115

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ATR-001423AZMDAthletic Trainer
10240AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Orthopedic Research and Education, LLC Physician Assistant CurrentSince Jul 1, 2024 Accepting new patients

Locations

18444 N 25th Ave
Ste 310
Phoenix, AZ 85023
Phone (623) 241-8706

10494 W Thunderbird Blvd
Ste 102
Sun City, AZ 85351
Phone (623) 975-8311

14420 W Meeker Blvd
Ste 300
Sun City West, AZ 85375
Phone (623) 583-5083

Interoperability endpoints

  • Direct secure messaging: carlos.villalpando.1@22724.direct.athenahealth.com

Organizations & group practices 1

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1104485184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18444 N 25TH AVE STE 310",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850231266",
            "telephone_number": "866-974-2673",
            "fax_number": "866-939-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14520 W GRANITE VALLEY DR STE 210",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853755855",
            "telephone_number": "866-974-2673",
            "fax_number": "866-939-2673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "230 S 3rd St",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850042697",
            "country_code": "US",
            "telephone_number": "602-553-3113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLALPANDO",
        "first_name": "CARLOS",
        "middle_name": "DANIEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-12",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "AZ",
            "license": "ATR-001423",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "10240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206057",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City West, AZ

Sources for this page

Verify at the official NPI Registry.