NPIMap

Organization Active NPI

Elite Medical Partners PLLC

  • Family Medicine Physician
  • Queen Creek, AZ
National Provider Identifier
1710599303
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ELITE MEDICAL PARTNERS PLLC
Practice address
20261 E Ocotillo Rd Ste 110
Queen Creek, AZ 85142-8806
Phone
(480) 805-1444
Fax
(480) 677-2768
NPI assigned
Aug 17, 2020
Last updated
Jul 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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

Authorized official

Name
Jillian Trulson, PA-CNPI 1104324623
Title
Owner
Phone
(480) 227-6683

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Physician Assistant 363A00000X NU
Medical Physician Assistant 363AM0700X NU

Addresses

Primary practice location

20261 E Ocotillo Rd Ste 110
Queen Creek, AZ 85142-8806

Mailing address

20261 E Ocotillo Rd Ste 110
Queen Creek, AZ 85142-8806
Phone (480) 805-1444

Other identifiers 3

IdentifierTypeStateIssuer
1104324623OtherNPI
12763749OtherCAQH
14949926OtherCAQH

National Provider Directory

National Provider Directory

Locations

20261 E Ocotillo Rd
Queen Creek, AZ 85142
Phone (480) 677-2771

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626912000000",
    "number": "1710599303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20261 E OCOTILLO RD STE 110",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851428806",
            "telephone_number": "480-805-1444",
            "fax_number": "480-677-2768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20261 E OCOTILLO RD STE 110",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851428806",
            "telephone_number": "480-805-1444",
            "fax_number": "480-677-2768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE MEDICAL PARTNERS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-17",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A",
        "authorized_official_last_name": "TRULSON",
        "authorized_official_first_name": "JILLIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-227-6683",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1104324623",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12763749",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14949926",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Queen Creek, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.