Individual provider Active NPI

Tiana Leilani Gomes, PA-C

  • Physician Assistant
  • Mesa, AZ
National Provider Identifier
1114540390
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1520 S Dobson Rd Ste 217
Mesa, AZ 85202-4754
Phone
(480) 539-4000
Fax
(480) 539-7033
NPI assigned
May 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary
Surgical Physician Assistant 363AS0400X 8529 AZ

Addresses

Primary practice location

1520 S Dobson Rd Ste 217
Mesa, AZ 85202-4754

Mailing address

4530 E Shea Blvd Ste 180
Phoenix, AZ 85028-6042
Phone (602) 264-4834

Other practice location 1

4365 E Pecos Rd Ste 103
Gilbert, AZ 85295-7888
Phone (480) 378-6323

Other practice location 2

4530 E Shea Blvd Ste 180
Phoenix, AZ 85028-6042
Phone (602) 264-4834

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
I20220621000904 AZ Practitioner - Physician Assistant 7911386016 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Honorhealth AmbulatoryGroup PAC ID 5991603110, 630 clinicians
Arizona Otolaryngology Consultants, PCGroup PAC ID 5294621868, 22 clinicians

Practice addresses (Care Compare)

10510 N 92ND St
Scottsdale, AZ 85258-4566

4530 E Shea Blvd
Suite 180
Phoenix, AZ 85028-6042
Phone (602) 264-4834

5015 S Arizona Mills Cir
Tempe, AZ 85282-6401
Phone (480) 534-4121

5750 W Thunderbird Rd
Suite A100
Glendale, AZ 85306-4661
Phone (602) 938-3205

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8529AZMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Pathology Current Accepting new patients
St. Joseph'S Outpatient Surgery Center, LLC Current Accepting new patients
St. Joseph'S Hospital and Medical Center CurrentSince Aug 30, 2020 Accepting new patients
Notre Dame Behavioral Health, PLLC PastSince Oct 1, 2021 Accepting new patients

Locations

350 W Thomas Rd
Phoenix, AZ 85013
Phone (480) 339-5001

240 W Thomas Rd
#301
Phoenix, AZ 85013
Phone (602) 406-6262

File 56765
Los Angeles, CA 90074

Interoperability endpoints

  • Direct secure messaging: tiana.gomes.1@24142.direct.athenahealth.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1590105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1114540390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4530 E SHEA BLVD STE 180",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850286042",
            "telephone_number": "602-264-4834",
            "fax_number": "602-254-5178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 S DOBSON RD STE 217",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024754",
            "telephone_number": "480-539-4000",
            "fax_number": "480-539-7033"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4365 E Pecos Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852957888",
            "country_code": "US",
            "telephone_number": "480-378-6323",
            "fax_number": "877-409-1511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4530 E Shea Blvd Ste 180",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850286042",
            "country_code": "US",
            "telephone_number": "602-264-4834",
            "fax_number": "602-254-5178",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOMES",
        "first_name": "TIANA",
        "middle_name": "LEILANI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-22",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "8529",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.