Individual provider Active NPI

Marilyn Lee Palen, PA-C

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1982684957
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2160 Issued in AZ
Practice address
1920 E Cambridge Ave Ste 302
Phoenix, AZ 85006-1464
Phone
(602) 933-5200
Fax
(602) 933-4272
NPI assigned
Jan 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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 2160 AZ Primary

Addresses

Primary practice location

1920 E Cambridge Ave Ste 302
Phoenix, AZ 85006-1464

Mailing address

1920 E Cambridge Ave Ste 302
Phoenix, AZ 85006-1464
Phone (602) 933-5200

Other identifiers 1

IdentifierTypeStateIssuer
453217-001MedicaidAZ

Other names 1

  • Marilyn Lee Tigges Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120411000829 AZ Practitioner - Physician Assistant 8224299649 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2160AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Children'S Medical Group CurrentSince Jan 25, 2012 Accepting new patients

Locations

1501 N Gilbert Rd
Ste 203
Gilbert, AZ 85234
Phone (602) 833-7320

5131 E Southern Ave
Mesa, AZ 85206
Phone (480) 833-5437

1432 S Dobson Rd
Ste 401
Mesa, AZ 85202
Phone (480) 658-0123

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

1920 E Cambridge Ave
Ste 302
Phoenix, AZ 85006
Phone (602) 279-1697

3200 E Camelback Rd
Ste 250
Phoenix, AZ 85018
Phone (602) 933-1814

Organizations & group practices 2

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": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1982684957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 E CAMBRIDGE AVE STE 302",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850061464",
            "telephone_number": "602-933-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 E CAMBRIDGE AVE STE 302",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850061464",
            "telephone_number": "602-933-5200",
            "fax_number": "602-933-4272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALEN",
        "first_name": "MARILYN",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-18",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "2160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "453217-001",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARILYN",
            "last_name": "TIGGES",
            "middle_name": "LEE",
            "credential": "P.A.-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.