DANIEL ANTHONY INDILICATO PA NPI 1659395655

NPI Information

NPI: 1659395655
Provider Name: DANIEL ANTHONY INDILICATO, PA
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
1094 S GILBERT RD
SUITE 203
GILBERT, AZ
ZIP 85296
Phone: (480) 882-4000
Get Directions

Daniel Anthony Indilicato, PA is a surgical physician assistant in Gilbert, AZ with 27 years of experience. Daniel Anthony Indilicato, PA NPI is 1659395655. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1094 S GILBERT RD
SUITE 203
GILBERT, AZ
ZIP 85296-445
Phone: (480) 882-4000

The NPI 1659395655 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/26/2006 and was last updated on 4/27/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical	4385	ARIZONA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000494574001	OTHER	NEW YORK	BLUE SHIELD
2	BB4737	MEDICARE ID-TYPE UNSPECIFIED	NEW YORK
3	S78632	MEDICARE UPIN	NEW YORK
4	040511001092	OTHER	NEW YORK	FIDELIS CARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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