Premier Physician's Group, Pllc is a medicare enrolled "Clinic/center - Pain" provider in Mesa, Arizona. Their current practice location is
4540 E Baseline Rd Ste 105, Mesa, Arizona. You can reach out to their office (for appointments etc.) via phone at
(480) 272-8944.
Premier Physician's Group, Pllc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Premier Physician's Group, Pllc
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 1568643047.
Healthcare Provider's Profile
Full Name | Premier Physician's Group, Pllc |
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Type | Facility |
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Speciality | Clinic/center - Pain |
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Location | 4540 E Baseline Rd Ste 105, Mesa, 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: 1568643047
- Provider Enumeration Date: 11/26/2007
- Last Update Date: 05/12/2021
Medicare PECOS Information:
- PECOS PAC ID: 8426139213
- Enrollment ID: O20080117000803
Medical Identifiers
Medical identifiers for Premier Physician's Group, Pllc such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1568643047 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
111N00000X | Chiropractor | (* (Not Available)) | Secondary |
207LP2900X | Anesthesiology - Pain Medicine | (* (Not Available)) | Secondary |
207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Secondary |
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
208100000X | Physical Medicine & Rehabilitation | (* (Not Available)) | Secondary |
2081P2900X | Physical Medicine & Rehabilitation - Pain Medicine | (* (Not Available)) | Secondary |
261QP3300X | Clinic/center - Pain | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Premier Physician's Group, Pllc acts as a billing entity for following providers:
Provider Name | Christopher S Ray |
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Provider Type | Practitioner - Anesthesiology |
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Provider Identifiers | NPI Number: 1548267131 PECOS PAC ID: 1658341326 Enrollment ID: I20040729000654 |
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Provider Name | Jason G Buchkowski |
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Provider Type | Practitioner - Chiropractic |
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Provider Identifiers | NPI Number: 1790871291 PECOS PAC ID: 4486690641 Enrollment ID: I20050628001385 |
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Provider Name | Joel Salter |
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Provider Type | Practitioner - Nurse Practitioner |
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Provider Identifiers | NPI Number: 1487831129 PECOS PAC ID: 6507920105 Enrollment ID: I20140722000874 |
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Provider Name | Shaun Hampton |
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Provider Type | Practitioner - Nurse Practitioner |
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Provider Identifiers | NPI Number: 1093261497 PECOS PAC ID: 3678858644 Enrollment ID: I20170315000379 |
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Provider Name | Kurt Angus Smalls-walker |
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Provider Type | Practitioner - Nurse Practitioner |
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Provider Identifiers | NPI Number: 1225556293 PECOS PAC ID: 0143573030 Enrollment ID: I20181023000897 |
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Provider Name | David Bennett Carlyon |
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Provider Type | Practitioner - Chiropractic |
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Provider Identifiers | NPI Number: 1881120079 PECOS PAC ID: 3870995574 Enrollment ID: I20210716000669 |
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Provider Name | Thomas John Hulm |
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Provider Type | Practitioner - Chiropractic |
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Provider Identifiers | NPI Number: 1083247852 PECOS PAC ID: 8022411032 Enrollment ID: I20210728003883 |
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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. Premier Physician's Group, Pllc 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 |
Premier Physician's Group, Pllc 4540 E Baseline Rd Ste 112, Mesa, AZ 85206-4616 Ph: (480) 272-8944 | Premier Physician's Group, Pllc 4540 E Baseline Rd Ste 105, Mesa, AZ 85206-4616 Ph: (480) 272-8944 |
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