Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Alexis Dianne Pedersen, PAC

Individual provider Medical Physician Assistant · NPI 1306425970

Alexis Dianne Pedersen, PAC is a Physician Assistant in Phoenix, Arizona. Qualified in 2021, 5 years ago. Practices with Arizona Urology Specialists PLLC, a 83-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
5
Licensed in
AZ
In the registry since
2021
Specialties on file
2
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

2902 W Agua Fria Fwy Ste 1000
Phoenix, AZ 85027-3969
Phone: (623) 582-6420
Fax: (623) 582-6720
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 8682 (AZ)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1306425970
Entity typeIndividual (Type 1)
GenderFemale
Credentials PAC
Sole proprietorYes
NPI enumeratedApril 2, 2021
Last updated in NPPESMarch 21, 2025
Certification dateMarch 21, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Arizona Urology Specialists Pllc — 83 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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