Antonio Teague

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

10813 Issued in AZ

Practice address

143 S 63Rd St Ste 100
Mesa, AZ 85206-1623

Phone

(480) 835-6100

Fax

(480) 461-4243

NPI assigned

Jun 5, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Tri-City Cardiology Consultants, PC

  • Cardiovascular Disease Physician
  • Mesa, AZ
  • NPI 1144288416
  Medicare reassignment NPD
• Tri-City Cardiology Consultants, PC

  • Cardiac Rehabilitation Registered Nurse
  • Mesa, AZ
  • NPI 1689417636
  NPD

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

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771804800000",
    "number": "1407540446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6343 E MAIN ST STE 12",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852058955",
            "telephone_number": "480-835-6100",
            "fax_number": "480-461-4243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 S 63RD ST STE 100",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061623",
            "telephone_number": "480-835-6100",
            "fax_number": "480-461-4243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEAGUE",
        "first_name": "ANTONIO",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-05",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "10813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Taylor, LCSW
• Whitney Taylor
• TBS Az LLC
• Celestine L. Tchikounzi, D.O
• TCSC Ev LLC
• Team Physicians of Arizona PC
• Charina F Tecson, MD
• Pacita Tee Opulencia, MD
• Teen Out Reach Services
• Mohamed Sameh Teleb, M.D.

• Medical Physician Assistant in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.