Individual provider Active NPI

Carlos Armando Perez, PA-C

  • Medical Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1457245953
Registry record updated Jan 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
11511 Issued in AZ
Practice address
4350 N 19TH Ave Ste 6
Phoenix, AZ 85015-4602
Phone
(602) 264-9191
Fax
(602) 230-8486
NPI assigned
Jun 7, 2025
Last updated
Jan 19, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 11511 AZ Primary

Addresses

Primary practice location

4350 N 19TH Ave Ste 6
Phoenix, AZ 85015-4602

Mailing address

3300 N 7TH Ave Unit 505
Phoenix, AZ 85013-4192
Phone (702) 682-2169

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
I20260121002039 AZ Practitioner - Physician Assistant 1557848520 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Touro Un Col of Osteopathic Medicine, Henderson, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pueblo Family Physicians LTDGroup PAC ID 2062497936, 8 clinicians

Practice addresses (Care Compare)

4350 N 19TH Ave
Suite 6
Phoenix, AZ 85015-4602
Phone (480) 607-1124

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11511AZMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pueblo Family Physicians LTD Single Specialty CurrentSince Jan 5, 2026 Accepting new patients

Locations

4350 N 19th Ave
Ste 6
Phoenix, AZ 85015
Phone (480) 607-1124

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": "1749254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768780800000",
    "number": "1457245953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 N 7TH AVE UNIT 505",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134192",
            "telephone_number": "702-682-2169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 N 19TH AVE STE 6",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850154602",
            "telephone_number": "602-264-9191",
            "fax_number": "602-230-8486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "CARLOS",
        "middle_name": "ARMANDO",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-07",
        "last_updated": "2026-01-19",
        "certification_date": "2026-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "11511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.