1St Care Wound Clinic PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

1ST CARE WOUND CLINIC PLLC

Practice address

10147 Grand Ave # C4
Sun City, AZ 85351-3435

Phone

(480) 588-5464

NPI assigned

Apr 24, 2024

Last updated

May 18, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rajesh Pillai, MD

Title

President

Phone

(480) 588-5464

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ruth Lynn Hoskins, F-NP

  • Family Nurse Practitioner
  • Mesa, AZ
  • NPI 1982013686
  Medicare reassignment Care Compare group NPD
• Janette E Trent, NP

  • Nurse Practitioner
  • Highlands Ranch, CO
  • NPI 1699798967

  AZ

  Medicare reassignment Care Compare group NPD
• Rajesh Thiraviam Pillai, MD

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1700801602
  Medicare reassignment NPD

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

{
    "created_epoch": "1713916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715990400000",
    "number": "1609622406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10147 GRAND AVE # C4",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853513435",
            "telephone_number": "480-588-5464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10147 GRAND AVE # C4",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853513435",
            "telephone_number": "480-588-5464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1635 W Glendale Ave",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850218813",
            "country_code": "US",
            "telephone_number": "480-588-5464",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "637 E Main St Ste B",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852038791",
            "country_code": "US",
            "telephone_number": "480-588-5464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "1ST CARE WOUND CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-24",
        "last_updated": "2024-05-18",
        "certification_date": "2024-05-18",
        "status": "A",
        "authorized_official_last_name": "PILLAI",
        "authorized_official_first_name": "RAJESH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-588-5464",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Sun City, AZ
• Providers in Sun City, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.