Individual provider Active NPI

Carla Melendez, PA

  • Physician Assistant
  • Goodyear, AZ
National Provider Identifier
1184499337
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10043 Issued in AZ
Practice address
140 N Litchfield Rd Ste 110
Goodyear, AZ 85338-1226
Phone
(602) 456-1835
NPI assigned
Nov 17, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10043 AZ Primary

Addresses

Primary practice location

140 N Litchfield Rd Ste 110
Goodyear, AZ 85338-1226

Mailing address

24654 N Lake Pleasant Pkwy
Ste 103 Mailbox 818
Peoria, AZ 85383
Phone (602) 598-1616

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
I20240119003599 AZ Practitioner - Physician Assistant 2860844354 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
Telehealth
Offers telehealth services
Group practices
Moore Advanced Orthopedics PLLCGroup PAC ID 7113394248, 2 clinicians

Practice addresses (Care Compare)

1616 N Litchfield Rd
Suite 240
Goodyear, AZ 85395-1288
Phone (602) 456-1835

Hospital & facility affiliations

  • Abrazo West Campus Hospital, Goodyear, AZ, CCN 030110
  • Wickenburg Community Hospital Hospital, Wickenburg, AZ, CCN 031300
  • La Paz Regional Hospital Hospital, Parker, AZ, CCN 031317
  • Abrazo Arrowhead Hospital Hospital, Glendale, AZ, CCN 030094

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10043AZMDPhysician Assistant

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 6

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": "1700179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1184499337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24654 N LAKE PLEASANT PKWY",
            "address_2": "STE 103 MAILBOX 818",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "85383",
            "telephone_number": "602-598-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 N LITCHFIELD RD STE 110",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853381226",
            "telephone_number": "602-456-1835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELENDEZ",
        "first_name": "CARLA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-17",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "10043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

Verify at the official NPI Registry.