NPIMap

Organization Active NPI

Arizona Urology LLC

  • Urology Physician
  • Goodyear, AZ
National Provider Identifier
1770025439
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
ARIZONA UROLOGY LLC
Practice address
13555 W McDowell Rd Ste 302
Goodyear, AZ 85395-2629
Phone
(623) 512-4390
Fax
(623) 512-4391
NPI assigned
Nov 12, 2016
Last updated
Jun 8, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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

Authorized official

Name
Dr. Pankaj M Jain, MDNPI 1730152422
Title
Managing Partner
Phone
(623) 512-4390

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X
Urology Physician 208800000X Primary

Addresses

Primary practice location

13555 W McDowell Rd Ste 302
Goodyear, AZ 85395-2629

Mailing address

13555 W McDowell Rd Ste 302
Goodyear, AZ 85395-2629
Phone (623) 512-4390

Other practice location 1

1926 A First Commercial Dr Ste 110
Southaven, MS 38671
Phone (623) 512-4390

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210928002657 AZ Part B Supplier - Clinic/Group Practice 9537566930 Receives reassigned benefits from 12 practitioners
Practice locations: Gilbert, AZ; Glendale, AZ; Goodyear, AZ; Phoenix, AZ
O20260421004262 MS Part B Supplier - Independent Clinical Laboratory 9537566930 Practice locations: Southaven, MS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D1102253Arizona Urology13555 W McDowell Rd, Suite 302, Goodyear, AZ 85395ComplianceJun 15, 2028
25D2336844Arizona Urology1926 A First Commerical Dr Suite 110, Southaven, MS 38671RegistrationJan 11, 2028

National Provider Directory

National Provider Directory

Locations

1488 W Elliot Rd
Gilbert, AZ 85233

17560 N 75th Ave
Ste 440
Glendale, AZ 85308
Phone (619) 985-6464

3815 E Bell Rd
Ste 4200
Phoenix, AZ 85032

9201 W Thomas Rd
Phoenix, AZ 85037
Phone (623) 327-4000

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1478908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780876800000",
    "number": "1770025439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13555 W MCDOWELL RD STE 302",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952629",
            "telephone_number": "623-512-4390",
            "fax_number": "623-512-4391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13555 W MCDOWELL RD STE 302",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952629",
            "telephone_number": "623-512-4390",
            "fax_number": "623-512-4391"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1926 A First Commercial Dr Ste 110",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "38671",
            "country_code": "US",
            "telephone_number": "623-512-4390",
            "fax_number": "623-512-4391",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ARIZONA UROLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-12",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A",
        "authorized_official_last_name": "JAIN",
        "authorized_official_first_name": "PANKAJ",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "623-512-4390",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.