Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ellayna Renee Wiedow Avila, PA-C

Individual provider Surgical Physician Assistant · NPI 1417435181

Ellayna Renee Wiedow Avila, PA-C is a Physician Assistant in Chandler, Arizona. Qualified in 2018, 8 years ago. Practices with Sjhmc Physician Services, a 665-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
8
Licensed in
AZ
In the registry since
2018
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

485 S Dobson Rd Ste 110
Chandler, AZ 85224-5600
Phone: (480) 728-4470
Fax: (480) 728-4499
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 7241 (AZ)

Record details

NPI number1417435181
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 3, 2018
Last updated in NPPESDecember 5, 2024
Certification dateDecember 5, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Sjhmc Physician Services — 665 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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