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MR. ANTONIO TEAGUE
NPI 1407540446
Physician Assistant - Medical in Mesa, AZ

Active since June 05, 2023PECOS Enrolled
143 S 63RD ST STE 100, MESA, AZ 85206(480) 835-6100(480) 461-4243 Get Directions Write a Review

NPPES record last updated: February 23, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Antonio Teague NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. ANTONIO TEAGUE (NPI 1407540446) is an individual medical provider in Mesa, Arizona, licensed in Arizona (10813) and active in the NPI registry since June 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1407540446
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameMR. ANTONIO TEAGUE
Location Address143 S 63RD ST STE 100Mesa, AZ 85206-1623
Mailing Address6343 E Main St Ste 12Mesa, AZ 85205-8955 · (480) 835-6100 · Fax (480) 461-4243
Phone(480) 835-6100
Fax(480) 461-4243
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateJune 5, 2023
Last NPPES UpdateFebruary 23, 2026
NPPES CertifiedFebruary 23, 2026
✔ NPI 1407540446 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in AZ · 10813
143 S 63RD ST STE 100, Mesa, AZ 85206
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Antonio Teague is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1759863764
PECOS Enrollment IDI20260306003373
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STEPHANIE ANN KILBORN
Family Medicine
143 S 63RD ST STE 100
MESA, AZ 85206
Maricopa County (480) 416-6140

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Antonio Teague's NPI number?

The NPI number for Antonio Teague is 1407540446. It was assigned to this individual provider in the NPPES registry on June 5, 2023.

Where is Antonio Teague located?

Antonio Teague practices at 143 S 63rd St Ste 100, Mesa, AZ 85206. The listed phone number is (480) 835-6100.

What is Antonio Teague's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Antonio Teague enrolled in Medicare?

Yes. Antonio Teague is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Antonio Teague was last updated on February 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.