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

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