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

Jason Banuelos, PA

Individual provider Physician Assistant · NPI 1699414870

Jason Banuelos, PA is a Physician Assistant in Phoenix, Arizona. Practices as a sole proprietor. Licensed in Arizona.

Licensed in
AZ
In the registry since
2022
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

435 N 5th St
Phoenix, AZ 85004-2157
Phone: (602) 827-2450
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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 9366 (AZ)

Record details

NPI number1699414870
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorYes
NPI enumeratedJune 3, 2022
Last updated in NPPESDecember 12, 2023
Certification dateDecember 12, 2023

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