Individual provider Active NPI

Ethan Kilduff, PT, DPT

  • Physical Therapist
  • Goodyear, AZ
National Provider Identifier
1376485094
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT-034683 Issued in AZ
Practice address
14545 W Indian School Rd
Goodyear, AZ 85395-9243
Phone
(623) 335-3736
NPI assigned
Apr 9, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X LPT-034683 AZ Primary

Addresses

Primary practice location

14545 W Indian School Rd
Goodyear, AZ 85395-9243

Mailing address

14545 W Indian School Rd
Goodyear, AZ 85395-9243

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260604003322 AZ Practitioner - Physical Therapist in Private Practice 1052882693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arizona Orthopedic Physical Therapy PLLCGroup PAC ID 9638177272, 23 clinicians

Practice addresses (Care Compare)

14557 W Indian School Rd
Suite 500
Goodyear, AZ 85395-9218
Phone (623) 242-6908

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPT-034683AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Orthopedic Physical Therapy, PLLC CurrentSince Apr 1, 2026 Accepting new patients

Locations

23350 W Yuma Rd
Buckeye, AZ 85326
Phone (623) 547-5260

14557 W Indian School Rd
Ste 500
Goodyear, AZ 85395
Phone (623) 229-7808

14557 W Indian School Rd
Goodyear, AZ 85395
Phone (623) 229-7808

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.

NPI Registry JSON

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

{
    "created_epoch": "1775692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1376485094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14545 W INDIAN SCHOOL RD",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853959243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14545 W INDIAN SCHOOL RD",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853959243",
            "telephone_number": "623-335-3736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILDUFF",
        "first_name": "ETHAN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-04-09",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-034683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.