Sandra E Aguayo, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

11687 Issued in AZ

Practice address

3015 Highway 95 Ste 105
Bullhead City, AZ 86442-4334

Phone

(928) 763-2001

Fax

(928) 763-2038

NPI assigned

Jul 25, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in UT, AZ2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prescott Healthcare Solutions LLCGroup PAC ID 4385940295, 199 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Prescott Healthcare Solutions LLC

  • Family Medicine Physician
  • Prescott, AZ
  • NPI 1821454505

  AZ

  Medicare reassignment Care Compare group
• Revere Health PC

  • Multi-Specialty Clinic/Center
  • Provo, UT
  • NPI 1093764805

  UT

  Medicare reassignment NPD
• Revere Health PC

  • Multi-Specialty Clinic/Center
  • Spanish Fork, UT
  • NPI 1851142285
  NPD

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

{
    "created_epoch": "1690243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1144900044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 HIGHWAY 95 STE 105",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864424334",
            "telephone_number": "928-763-2001",
            "fax_number": "928-763-2038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 HIGHWAY 95 STE 105",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864424334",
            "telephone_number": "928-763-2001",
            "fax_number": "928-763-2038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "264 W 100 S",
            "address_purpose": "LOCATION",
            "city": "Santaquin",
            "state": "UT",
            "postal_code": "846558012",
            "country_code": "US",
            "telephone_number": "385-203-1250",
            "fax_number": "801-418-0941",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3714 E Campus Dr Ste 106",
            "address_purpose": "LOCATION",
            "city": "Eagle Mountain",
            "state": "UT",
            "postal_code": "840055453",
            "country_code": "US",
            "telephone_number": "385-203-1250",
            "fax_number": "801-418-0941",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1055 N 500 W",
            "address_2": "Building A",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846043305",
            "country_code": "US",
            "telephone_number": "801-812-5033",
            "fax_number": "801-418-0941",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 Canyon Rd Ste A1",
            "address_purpose": "LOCATION",
            "city": "Bullhead City",
            "state": "AZ",
            "postal_code": "864428492",
            "country_code": "US",
            "telephone_number": "928-704-4499",
            "fax_number": "928-704-4949",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGUAYO",
        "first_name": "SANDRA",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-25",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "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": "AZ",
            "license": "11687",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "14041377-1206",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abc Therapy, Inc.
• Joe W Abdelnour, DDS MS
• Andrew Acevedo
• Courtney Acton, PHARM D
• Affordable Dentures & Implants - Bullhead City V, P.C.
• Mohamed S Ahmed, M.D.
• Ajmedicus
• Akdhc Surgery Center, LLC
• Akdhc Surgery Center, LLC
• Akdhc, LLC

• All providers in Bullhead City, AZ
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.