Individual provider Active NPI

Peter Duong, PA

  • Physician Assistant
  • Mesa, AZ
National Provider Identifier
1336964022
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10938 Issued in AZ
Practice address
4135 S Power Rd Ste 129
Mesa, AZ 85212-3627
Phone
(480) 751-3091
Fax
(480) 840-9320
NPI assigned
Nov 19, 2024
Last updated
Jul 28, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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 10938 AZ Primary

Addresses

Primary practice location

4135 S Power Rd Ste 129
Mesa, AZ 85212-3627

Mailing address

4135 S Power Rd Ste 129
Mesa, AZ 85212-3627
Phone (480) 751-3091

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
I20250507002988 AZ Practitioner - Physician Assistant 2769909308 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prescott Healthcare Solutions LLCGroup PAC ID 4385940295, 199 clinicians

Practice addresses (Care Compare)

4135 S Power Rd
Suite 129
Mesa, AZ 85212-3627
Phone (480) 751-3091

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prescott Healthcare Solutions LLC CurrentSince Dec 1, 2025 Accepting new patients

Locations

560 N Camino Mercado
Casa Grande, AZ 85122

560 N Camino Mercado
Ste 7
Casa Grande, AZ 85122
Phone (520) 836-5538

4135 S Power Rd
Ste 129
Mesa, AZ 85212
Phone (480) 751-3091

8914 N 91st Ave
Ste 100
Peoria, AZ 85345
Phone (623) 877-0100

3151 N Windsong Dr
Prescott Vly, AZ 86314
Phone (928) 458-7583

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1731974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1336964022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4135 S POWER RD STE 129",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852123627",
            "telephone_number": "480-751-3091",
            "fax_number": "480-840-9320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4135 S POWER RD STE 129",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852123627",
            "telephone_number": "480-751-3091",
            "fax_number": "480-840-9320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUONG",
        "first_name": "PETER",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-11-19",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "10938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.