|
| |
|
5202 E. Main Street, Suite #105, Mesa, AZ 85205-8038 | |
| (480) 218-1328 | |
| (480) 218-1330 |
| Full Name | |
|---|---|
| Type | Facility |
| Speciality | Audiologist |
| Location | 5202 E. Main Street, Mesa, Arizona |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881708261 | NPI | - | NPPES |
| 1881708261 | Other | AZ | GROUP NPI |
| 894164 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 231H00000X | Audiologist | DA2043 (Arizona) | Primary |
| Provider Name | Adam Dipuccio |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1396791141 PECOS PAC ID: 8527034354 Enrollment ID: I20040903000189 |
| Provider Name | Gary M Johnson |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1417118217 PECOS PAC ID: 4486727344 Enrollment ID: I20080725000066 |
| Provider Name | Cassandra M Schmidt |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1528358454 PECOS PAC ID: 2668658196 Enrollment ID: I20110518000662 |
| Provider Name | Christina M Gabler |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1639255136 PECOS PAC ID: 8820241078 Enrollment ID: I20130121000168 |
| Provider Name | Kelly M Lewis |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1073999579 PECOS PAC ID: 5092020412 Enrollment ID: I20150813012298 |
| Provider Name | Amanda N Blackburn |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1487212775 PECOS PAC ID: 4385076876 Enrollment ID: I20191121002969 |
| Provider Name | Jessie-anne P Penkoff |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1043863350 PECOS PAC ID: 1355773128 Enrollment ID: I20200318000668 |
| Provider Name | Aryana Arae Nevarez |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1780313858 PECOS PAC ID: 2466832704 Enrollment ID: I20220705002489 |
| Mailing Address | Practice Location Address |
|---|---|
5202 E. Main Street, Suite #105, Mesa, AZ 85205-8038 Ph: (480) 218-1328 | 5202 E. Main Street, Suite #105, Mesa, AZ 85205-8038 Ph: (480) 218-1328 |
Jennifer Sellinger, Audiologist Medicare: Not Enrolled in Medicare Practice Location: 1025 N Country Club Dr, Mesa, AZ 85201 Phone: 480-472-0510 | |
Dr. Elizabeth Dawn Palmer, AUD Audiologist Medicare: Medicare Enrolled Practice Location: 4838 E Baseline Rd Ste 126, Mesa, AZ 85206 Phone: 480-265-8067 Fax: 623-806-8685 | |
Olivia H Bender, AUD Audiologist Medicare: Medicare Enrolled Practice Location: 1520 S Dobson Rd Ste 217, Mesa, AZ 85202 Phone: 480-539-4000 | |
Mr. Jared Michael Henry-gent, AU.D. Audiologist Medicare: Accepting Medicare Assignments Practice Location: 6553 E Baywood Ave Ste 104, Mesa, AZ 85206 Phone: 480-981-3384 Fax: 480-924-8944 | |
Tri-city Audiology, Llc Audiologist Medicare: Medicare Enrolled Practice Location: 6553 E Baywood Ave Ste 104, Mesa, AZ 85206 Phone: 480-981-3384 Fax: 480-924-8944 | |
Edgeline Audiology Pllc Audiologist Medicare: Not Enrolled in Medicare Practice Location: 4140 E Baseline Rd Ste 101, Mesa, AZ 85206 Phone: 480-545-2215 |