Individual provider Active NPI

Ernesto Iniguez Jr., MD

  • Student in an Organized Health Care Education/Training Program
  • Surprise, AZ
National Provider Identifier
1184411738
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
R81691 Issued in AZ
Practice address
13995 W Statler Blvd Ste 200
Surprise, AZ 85374-5503
Phone
(602) 478-3100
NPI assigned
Apr 24, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X R81691 AZ Primary

Addresses

Primary practice location

13995 W Statler Blvd Ste 200
Surprise, AZ 85374-5503

Mailing address

13995 W Statler Blvd Ste 200
Surprise, AZ 85374-5503
Phone (602) 478-3100

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250701002995 AZ Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 8527571652

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R81691AZMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1745452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1184411738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13995 W STATLER BLVD STE 200",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853745503",
            "telephone_number": "602-478-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13995 W STATLER BLVD STE 200",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853745503",
            "telephone_number": "602-478-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INIGUEZ",
        "first_name": "ERNESTO",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-24",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AZ",
            "license": "R81691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

Verify at the official NPI Registry.