NPIMap

Individual provider Active NPI

Gregory J Cordes, PA

  • Physician Assistant
  • Peoria, AZ
National Provider Identifier
1902185747
Registry record updated Apr 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4939 Issued in AZ
Practice address
7727 W Deer Valley Rd
Suite 210
Peoria, AZ 85382-2116
Phone
(602) 406-1200
Fax
(602) 406-1212
NPI assigned
Aug 10, 2011
Last updated
Apr 23, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4939 AZ Primary

Addresses

Primary practice location

7727 W Deer Valley Rd
Suite 210
Peoria, AZ 85382-2116

Mailing address

File 56765
Los Angeles, CA 90074-6765
Phone (602) 406-3860

Other identifiers 1

IdentifierTypeStateIssuer
648303MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, MT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20111130000921 AZ Practitioner - Physician Assistant 0840464871 Reassigns benefits to 2 organizations
I20250107000815 MT Practitioner - Physician Assistant 0840464871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mednorth Kalispell Urgent Care Clinic, LLCGroup PAC ID 3274680673, 7 clinicians

Practice addresses (Care Compare)

2316 US Hwy 93 N
Kalispell, MT 59901-2547
Phone (406) 755-5661

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
65.27 of 100Reported as group
Quality
45.09
Improvement activities
40
Cost
66.23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4939AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dispatchhealth-Arizona CurrentSince Nov 1, 2022 Accepting new patients
Greater Phoenix Emergency Physicians Inc Past Accepting new patients
Ultimate Urgent Care Centers Past Accepting new patients
Ucxtra Umbrella, LLC Past Accepting new patients

Locations

4602 E University Dr
Ste 150
Phoenix, AZ 85034
Phone (480) 493-3444

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 7

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": "1312934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335139200000",
    "number": "1902185747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE 56765",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900746765",
            "telephone_number": "602-406-3860",
            "fax_number": "602-406-6132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7727 W DEER VALLEY RD",
            "address_2": "SUITE 210",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853822116",
            "telephone_number": "602-406-1200",
            "fax_number": "602-406-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDES",
        "first_name": "GREGORY",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-10",
        "last_updated": "2012-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "4939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "648303",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.