Individual provider Active NPI

Gabriel Jose Arredondo Arriola, PA

  • Physician Assistant
  • Rogers, AR
National Provider Identifier
1710657952
Registry record updated Feb 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA18267 Issued in TX
Practice address
2710 S Rife Medical LN
Rogers, AR 72758-1452
Phone
(479) 338-8000
NPI assigned
Sep 19, 2021
Last updated
Feb 10, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-1023 AR
Emergency Medicine Physician 207P00000X PT2021-072 AR
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA18267 TX Primary

Addresses

Primary practice location

2710 S Rife Medical LN
Rogers, AR 72758-1452

Mailing address

1322 Fifth Ave
Lowell, AR 72745-8077
Phone (479) 214-8247

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, TX, OK3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20211213002768 AR Practitioner - Physician Assistant 1254721863 Reassigns benefits to 2 organizations
I20241011002312 TX Practitioner - Physician Assistant 1254721863 Reassigns benefits to 4 organizations
I20251028002850 OK Practitioner - Physician Assistant 1254721863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ies ER Oklahoma LLCGroup PAC ID 5395234678, 135 clinicians

Practice addresses (Care Compare)

6161 S Yale Ave
Tulsa, OK 74136-1902
Phone (918) 494-2200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.43 of 100Reported as group
Quality
93.73
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5742OKMDMental Health Counselor
PT2021-072ARMDEmergency Medicine Physician
PA-1023ARMDPhysician Assistant
PA18267TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ies ER Oklahoma LLC Emergency Medicine CurrentSince Oct 9, 2025 Accepting new patients

Locations

10501 E 91st St
Tulsa, OK 74133
Phone (918) 307-6000

6161 S Yale Ave
Tulsa, OK 74136
Phone (918) 494-2200

Organizations & group practices 7

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": "1632009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770681600000",
    "number": "1710657952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1322 FIFTH AVE",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727458077",
            "telephone_number": "479-214-8247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 S RIFE MEDICAL LN",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581452",
            "telephone_number": "479-338-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARREDONDO ARRIOLA",
        "first_name": "GABRIEL",
        "middle_name": "JOSE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-19",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA-1023",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "PT2021-072",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA18267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

Verify at the official NPI Registry.