Individual provider Active NPI

Angelica Lee Luiz, PA-C

  • Physician Assistant
  • Morenci, AZ
National Provider Identifier
1457067761
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
401 Burro Aly
Morenci, AZ 85540-9647
Phone
(928) 865-9184
NPI assigned
Jan 30, 2023
Last updated
Sep 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary
Medical Physician Assistant 363AM0700X PA61621503 WA

Addresses

Primary practice location

401 Burro Aly
Morenci, AZ 85540-9647

Mailing address

401 Burro Aly
Morenci, AZ 85540-9647

Other practice location 1

4205 Kitsap Way
Bremerton, WA 98312-2447
Phone (360) 782-7780

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250513001039 AZ Practitioner - Physician Assistant 4183142292 Reassigns benefits to 1 organization
I20251003003607 WA Practitioner - Physician Assistant 4183142292 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

1812 S J St
Suite 120
Tacoma, WA 98405-4965
Phone (253) 428-2200

4205 Kitsap Way
Bremerton, WA 98312-2447
Phone (360) 782-7780

4207 Kitsap Way
Bremerton, WA 98312-2447
Phone (360) 415-1080

450 S Kitsap Blvd
Suite 100
Port Orchard, WA 98366-3709
Phone (360) 895-7620

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA61621503WAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince Sep 1, 2025 Accepting new patients
Franciscan Medical Group CurrentSince Sep 1, 2025 Accepting new patients
Franciscan Medical Group Physician Assistant Past Accepting new patients

Locations

4205 Kitsap Way
Bremerton, WA 98312
Phone (360) 782-7780

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Interoperability endpoints

  • Direct secure messaging: aluiz915618@fhsce.catholichealth.net

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1675036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758240000000",
    "number": "1457067761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 BURRO ALY",
            "city": "MORENCI",
            "state": "AZ",
            "postal_code": "855409647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BURRO ALY",
            "city": "MORENCI",
            "state": "AZ",
            "postal_code": "855409647",
            "telephone_number": "928-865-9184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4205 Kitsap Way",
            "address_purpose": "LOCATION",
            "city": "Bremerton",
            "state": "WA",
            "postal_code": "983122447",
            "country_code": "US",
            "telephone_number": "360-782-7780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUIZ",
        "first_name": "ANGELICA",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-30",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA61621503",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morenci, AZ

Sources for this page

Verify at the official NPI Registry.