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

Mr. Ejerzain Aniles- Renova

Individual provider Physician Assistant · NPI 1053873109

Mr. Ejerzain Aniles- Renova is a Physician Assistant in Phoenix, Arizona. Qualified in 2019, 7 years ago. Practices with Mayo Clinic Arizona, a 1,616-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
7
Licensed in
AZ
In the registry since
2019
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Practice location Address checks out

435 N 5th St
Phoenix, AZ 85004-2157
Phone: (602) 515-5001
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 5777 E Mayo Blvd, Phoenix, AZ 85054-4502 — (480) 342-1800

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 7602 (AZ)

Record details

NPI number1053873109
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 5, 2019
Last updated in NPPESOctober 20, 2020
Certification dateOctober 20, 2020
Mailing address219 W Piedmont Rd, Phoenix, AZ 85041-8846

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Mayo Clinic Arizona — 1616 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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