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

Edgar D Cornejo, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1912660440

Edgar D Cornejo, PHYSICIANASSISTANT is a Physician Assistant in Goodyear, Arizona. Qualified in 1996, 30 years ago. Practices with Arizona Health Services PLLC, a 5-clinician group and accepts Medicare assignment. Licensed in Puerto Rico.

Years since qualifying
30
Licensed in
PR
In the registry since
2021
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Practice location Address checks out

14175 W Indian School Rd Ste B4-120
Goodyear, AZ 85395-8407
Phone: (956) 222-7774
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 1100-P.A. (PR)

Record details

NPI number1912660440
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedOctober 21, 2021
Last updated in NPPESJanuary 11, 2022
Certification dateJanuary 11, 2022
Mailing address14175 W Indian School Rd Ste B4-120, Goodyear, AZ 85395-8407

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1996 (30 years in practice)
Group practice Arizona Health Services Pllc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Goodyear