Active NPI
Randall A Pence, PA-C
- Medical Physician Assistant
- Phoenix, AZ
National Provider Identifier
1770576720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- AZ3194
- Practice address
- 4350 N 19TH Ave
Suite #6
Phoenix, AZ 85015-4602 - Phone
- (602) 264-9191
- Fax
- (602) 532-2973
- NPI assigned
- Aug 24, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | AZ3194 | AZ | Primary |
Addresses
Primary practice location
4350 N 19TH Ave
Suite #6
Phoenix, AZ 85015-4602
Mailing address
4350 N 19TH Ave
Suite #6
Phoenix, AZ 85015-4602
Phone (602) 264-9191
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3194 | AZ | MD | Occupational Therapist |
| AZ3194 | AZ | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arthritis Care Specialists PC | Past | Accepting new patients | |
| Hanford Community Hospital | Past | Accepting new patients | |
| Arthritis Health, LTD | Past | Accepting new patients | |
| Will Jeffers D.O., P.C. | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Rheumatology Physician
- Phoenix, AZ
- NPI 1689996886
-
- Rheumatology Physician
- Scottsdale, AZ
- NPI 1649487091
-
dba Adventist Health Hanford
- General Acute Care Hospital
- Hanford, CA
- NPI 1538141627
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1770576720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4350 N 19TH AVE",
"address_2": "SUITE #6",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850154602",
"telephone_number": "602-264-9191",
"fax_number": "602-532-2973"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4350 N 19TH AVE",
"address_2": "SUITE #6",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850154602",
"telephone_number": "602-264-9191",
"fax_number": "602-532-2973"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENCE",
"first_name": "RANDALL",
"middle_name": "A",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-24",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "AZ",
"license": "AZ3194",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.