Premier Physicians Group, Pllc is a medicare enrolled "Clinic/center - Pain" provider in Mesa, Arizona. Their current practice location is
1955 S Val Vista Dr Ste 126, Mesa, Arizona. You can reach out to their office (for appointments etc.) via phone at
(480) 272-8944.
Premier Physicians Group, Pllc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Premier Physicians 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 Physicians Group, Pllc |
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| Type | Facility |
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| Speciality | Clinic/center - Pain |
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| Location | 1955 S Val Vista Dr Ste 126, 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. |
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NPI Data:
- NPI Number: 1568643047
- Provider Enumeration Date: 11/26/2007
- Last Update Date: 01/10/2025
Medicare PECOS Information:
- PECOS PAC ID: 8426139213
- Enrollment ID: O20080117000803
Medical Identifiers
Medical identifiers for Premier Physicians 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 |
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| 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 Physicians 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 Physicians 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 Physicians Group, Pllc
1955 S Val Vista Dr Ste 126,
Mesa, AZ 85204-7372
Ph: (480) 272-8944 | Premier Physicians Group, Pllc
1955 S Val Vista Dr Ste 126,
Mesa, AZ 85204-7372
Ph: (480) 272-8944 |
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