NPIMap

Organization Active NPI

Feliz Family Care, PLLC

  • Family Medicine Physician
  • Glendale, AZ
National Provider Identifier
1184497778
Registry record updated Jan 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FELIZ FAMILY CARE, PLLC
Practice address
5104 N 67TH Ave
Glendale, AZ 85301-6541
Phone
(602) 773-1234
NPI assigned
Nov 6, 2023
Last updated
Jan 21, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
FELIZ FAMILY CARE, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 21, 2024

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

Authorized official

Name
Roman Carrasco
Title
Director
Phone
(480) 404-7158

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

5104 N 67TH Ave
Glendale, AZ 85301-6541

Mailing address

1345 E Main St Ste 100
Mesa, AZ 85203-8950
Phone (480) 264-3711

Other names 1

  • Feliz Care Centers PLLC Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Feliz Care Centers PLLC8 organizations share this tax ID, including this one
Part of
Feliz Care Centers PLLC

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1345 E Main St
Ste 100
Mesa, AZ 85203
Phone (480) 264-3711

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705795200000",
    "number": "1184497778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 E MAIN ST STE 100",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852038950",
            "telephone_number": "480-264-3711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5104 N 67TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853016541",
            "telephone_number": "602-773-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FELIZ FAMILY CARE, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FELIZ FAMILY CARE, PLLC",
        "enumeration_date": "2023-11-06",
        "last_updated": "2024-01-21",
        "certification_date": "2024-01-21",
        "status": "A",
        "authorized_official_last_name": "CARRASCO",
        "authorized_official_first_name": "ROMAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "480-404-7158"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Feliz Care Centers PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.