Organization Active NPI

Elite Medical Aesthetics PLLC

  • Internal Medicine Physician
  • Tempe, AZ
National Provider Identifier
1194567230
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ELITE MEDICAL AESTHETICS PLLC
Practice address
123 E Baseline Rd Ste D204
Tempe, AZ 85283-1298
Phone
(480) 522-8875
Fax
(844) 266-9539
NPI assigned
Jun 10, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Authorized official

Name
Ms. Elsa Cedillo, FNPNPI 1760840391
Title
Owner
Phone
(480) 522-8875

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

123 E Baseline Rd Ste D204
Tempe, AZ 85283-1298

Mailing address

123 E Baseline Rd Ste D204
Tempe, AZ 85283-1298
Phone (480) 522-8875

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240923000886 AZ Part B Supplier - Clinic/Group Practice 0749721470 Receives reassigned benefits from 1 practitioner
Practice locations: Chandler, AZ; Tempe, AZ; Gilbert, AZ

National Provider Directory

National Provider Directory

Locations

123 E Baseline Rd
Ste D204
Tempe, AZ 85283
Phone (480) 522-8875

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754956800000",
    "number": "1194567230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 E BASELINE RD STE D204",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852831298",
            "telephone_number": "480-522-8875",
            "fax_number": "844-266-9539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 E BASELINE RD STE D204",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852831298",
            "telephone_number": "480-522-8875",
            "fax_number": "844-266-9539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE MEDICAL AESTHETICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-10",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A",
        "authorized_official_last_name": "CEDILLO",
        "authorized_official_first_name": "ELSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-522-8875",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.