Individual provider Active NPI

Alvaro Pinilla, PA

  • Medical Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1972290526
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
10333 Issued in AZ
Practice address
1141 E Glendale Ave
Phoenix, AZ 85020-5316
Phone
(328) 186-2478
Fax
(602) 229-8560
NPI assigned
Apr 21, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 10333 AZ Primary
Medical Physician Assistant 363AM0700X 1636-P-A PR

Addresses

Primary practice location

1141 E Glendale Ave
Phoenix, AZ 85020-5316

Mailing address

636 W Southern Ave
Mesa, AZ 85210-5005
Phone (832) 818-6247

Other practice location 1

636 W Southern Ave
Mesa, AZ 85210-5005
Phone (832) 818-6247

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250123001908 AZ Practitioner - Physician Assistant 4486606399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Latino Care LLCGroup PAC ID 0648403618, 3 clinicians

Practice addresses (Care Compare)

3102 E Indian School Rd
Suite 130
Phoenix, AZ 85016-6872
Phone (602) 353-6656

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1636-P-APRMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Latino Care, LLC CurrentSince Jun 28, 2025 Accepting new patients
South Main Clinic, Inc CurrentSince Dec 1, 2004 Accepting new patients
Latino Care, LLC CurrentSince Jun 28, 2025 Accepting new patients

Locations

3102 E Indian School Rd
Ste 130
Phoenix, AZ 85016
Phone (602) 252-0202

5847 S 16th St
Phoenix, AZ 85040
Phone (602) 268-3451

3140 N 35th Ave
Ste 7
Phoenix, AZ 85017
Phone (602) 353-6656

12333 Main St
Houston, TX 77035
Phone (713) 729-7600

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1682035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1972290526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 W SOUTHERN AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852105005",
            "telephone_number": "832-818-6247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 E GLENDALE AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850205316",
            "telephone_number": "328-186-2478",
            "fax_number": "602-229-8560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "636 W Southern Ave",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852105005",
            "country_code": "US",
            "telephone_number": "832-818-6247",
            "fax_number": "602-229-8560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PINILLA",
        "first_name": "ALVARO",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-21",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "10333",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PR",
            "license": "1636-P-A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.