DANIEL ANTHONY INDILICATO (NPI# 1659395655) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659395655 |
| Entity Type | Individual |
| Full Name | DANIEL ANTHONY INDILICATO |
| Credential | PA |
| Practice Address |
1094 S Gilbert Rd Suite 203 Gilbert AZ 85296-3445 |
| Mailing Address |
Po Box 8131 Scottsdale AZ 85252-8131 |
| Practice Telephone | 4808824000 |
| Mailing Telephone | 4808824000 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2010-04-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
4385 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | BLUE SHIELD | 000494574001 | 01 |
| NY | FIDELIS CARE | 040511001092 | 01 |
| Street Address |
1094 S GILBERT RD SUITE 203 |
| City | GILBERT |
| State | AZ |
| Zip Code | 85296-3445 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194785535 | Aaron Allen | Physician Assistant | 1094 S Gilbert Rd, Suite 203, Gilbert, AZ 85296-3445 | 2006-03-27 |
| 1609181403 | Darin A Rudd | Massage Therapist | 1094 S Gilbert Rd, Suite 214, Gilbert, AZ 85296-3445 | 2010-08-17 |
| 1811172687 | Infinite Wellness Chiropractic | Chiropractor | 1094 S Gilbert Rd, Bldg. B-2 Suite 103, Gilbert, AZ 85296-3445 | 2007-12-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124625793 | Gilbert Crossroads Kids' Dentists and Orthodontics, LLP | Dentist | 835 S. Gilbert Rd, Suite 104, Gilbert, AZ 85296 | 2020-10-06 |
| 1306455969 | Calm Care Living | Community/Behavioral Health | 1525 S Higley Rd, #104-6769, Gilbert, AZ 85296 | 2020-07-29 |
| 1366080970 | Hannah Golladay | Behavior Technician | 1166 S Gilbert Road, Suite 106, Mesa, AZ 85296 | 2019-12-13 |
| 1194284729 | Kege Health, LLC | Nurse Practitioner | 1206 E Warner Rd Ste 101f, Gilbert, AZ 85296 | 2019-03-13 |
| 1841757762 | Windhorse Counseling | Counselor | 1166 E Warner Road, Suite 203, Gilbert, AZ 85296 | 2019-02-27 |
| 1417424284 | Ashton N Wright | Behavior Technician | 1166 E Gilbert Rd, #106, Gilbert, AZ 85296 | 2018-10-30 |
| 1346717246 | Robison Orthodontics LLC | Dentist | 1355 S Higley Rd # 105, Gilbert, AZ 85296 | 2018-10-29 |
| 1518441831 | Kara Lyn Holyoak | Physician Assistant | 1359 S. Porter St., Gilbert, AZ 85296 | 2018-09-21 |
| 1225519119 | Jennifer Anne Goodman | Specialist/Technologist | 70 S Val Vista Dr A3, Gilbert, AZ 85296 | 2018-08-28 |
| 1437642329 | Greta Shumway | Counselor | 690 E. Warner Road, #115, Gilbert, AZ 85296 | 2018-06-14 |
| Find all providers in zip 85296 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912496712 | Hw Surgical Assist, Pllc | Physician Assistant | 4057 E Laurel Ave, Gilbert, AZ 85234 | 2018-05-07 |
| 1144658022 | Nicole Freeze | Physician Assistant | Bmda-banner Gateway Medical Center, 1900 N. Higley Road, Gilbert, AZ 85234 | 2013-10-31 |
| 1235349168 | Debra K Hatton | Physician Assistant | 3684 E Sierra Madre Ave, Gilbert, AZ 85296-1883 | 2007-05-22 |
| 1831115690 | Evans Surgical Associates PC | Physician Assistant | 1325 N Fiesta Blvd Ste 3, Gilbert, AZ 85233-1609 | 2006-07-14 |
| 1649229006 | Richard A Lease | Physician Assistant | 2966 E Warbler Rd, Gilbert, AZ 85297-8145 | 2006-05-10 |
| 1023072121 | Chris Brooks | Physician Assistant | 1150 W Sherri Dr, Gilbert, AZ 85233-7944 | 2006-04-14 |
| 1649233040 | Jose Luis Guzman | Physician Assistant | 1325 N Fiesta Blvd, Suite 3, Gilbert, AZ 85233-1609 | 2006-04-08 |
| 1194785535 | Aaron Allen | Physician Assistant | 1094 S Gilbert Rd, Suite 203, Gilbert, AZ 85296-3445 | 2006-03-27 |
| 1417957556 | Beth Erickson Foley | Physician Assistant | 2940 E Banner Gateway Dr, Suite 200, Gilbert, AZ 85234-2168 | 2005-07-29 |
| 1114558491 | Colby Rhel Horton | Physician Assistant | 2946 E Banner Gateway Drive, Gilbert, AZ 85234 | 2020-01-27 |
| Find all providers in GILBERT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.