Munderloh Medical Llc is a medicare enrolled "General Practice" provider in Flagstaff, Arizona. Their current practice location is
1501 S Yale St, 250, Flagstaff, Arizona. You can reach out to their office (for appointments etc.) via phone at
(928) 556-0707.
Munderloh Medical Llc is licensed to practice in Arizona (license number 005517) and it also participates in the medicare program. Munderloh Medical Llc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1578910295.
Healthcare Provider's Profile
Full Name | Munderloh Medical Llc |
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Type | Facility |
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Speciality | General Practice |
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Location | 1501 S Yale St, Flagstaff, Arizona |
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Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1578910295
- Provider Enumeration Date: 05/23/2016
- Last Update Date: 05/23/2016
Medicare PECOS Information:
- PECOS PAC ID: 8820381957
- Enrollment ID: O20160726002915
Medical Identifiers
Medical identifiers for Munderloh Medical Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1578910295 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
111NN0400X | Chiropractor - Neurology | 5935 (Arizona) | Secondary |
208D00000X | General Practice | 005517 (Arizona) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Munderloh Medical Llc acts as a billing entity for following providers:
Provider Name | Timothy James Munderloh |
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Provider Type | Practitioner - Chiropractic |
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Provider Identifiers | NPI Number: 1104883164 PECOS PAC ID: 6901897156 Enrollment ID: I20040519000089 |
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Provider Name | Cynthia Adson |
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Provider Type | Practitioner - Nurse Practitioner |
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Provider Identifiers | NPI Number: 1407500705 PECOS PAC ID: 8921495474 Enrollment ID: I20220502000273 |
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Provider Name | Sarah Elizabeth Puente |
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Provider Type | Practitioner - Chiropractic |
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Provider Identifiers | NPI Number: 1548834880 PECOS PAC ID: 5294111316 Enrollment ID: I20220927002624 |
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Provider Name | Cynthia Adson |
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Provider Type | Practitioner - Nurse Practitioner |
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Provider Identifiers | NPI Number: 1407500705 PECOS PAC ID: 8921495474 Enrollment ID: I20240418002896 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Munderloh Medical Llc is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Munderloh Medical Llc 1501 S Yale St, 250, Flagstaff, AZ 86001-7304 Ph: (928) 556-0707 | Munderloh Medical Llc 1501 S Yale St, 250, Flagstaff, AZ 86001-7304 Ph: (928) 556-0707 |
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