Amanda Phuong Thao Pendelton

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

4360 E Brown Rd Ste 111
Mesa, AZ 85205-4084

Phone

(623) 522-5871

Fax

(480) 222-1457

NPI assigned

Feb 19, 2024

Last updated

Jun 24, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Amanda Phuong Thao Nguyen Former name

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ati Holdings of Arizona LLCGroup PAC ID 2466732862, 223 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Ati Holdings of Arizona, LLC

  dba ATI Physical Therapy

  • Physical Therapist
  • Phoenix, AZ
  • NPI 1871570309
  Medicare reassignment Care Compare group NPD
• Ideal Rehabilitation LLC

  • Durable Medical Equipment & Medical Supplies
  • Tucson, AZ
  • NPI 1831353614
  NPD (past)

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

{
    "created_epoch": "1708300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1972368918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4360 E BROWN RD STE 111",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852054084",
            "telephone_number": "623-522-5871",
            "fax_number": "480-222-1457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDELTON",
        "first_name": "AMANDA",
        "middle_name": "PHUONG THAO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-19",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "NGUYEN",
            "middle_name": "PHUONG THAO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Liceett Pena, FNP-C
• Lisette Pena, LM, CPM
• Merenthia Pena, RBT
• Noelia Pena, PA
• Rogelio Pena, RD
• Allison Michelle Pendgraft, SLPA
• Terry Lynn Penner, MS ANP-C ACNP-BC
• Emily Padgett Pennington, MS OT/L
• Sabrina Pennyman, COTA/L
• Garrett Michael Penrod, CPT

• Physical Therapist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.