| Desert Pain And Rehab Specialists | |
|
11047 N 19th Ave Phoenix AZ 85029 | |
| (602) 944-2222 | |
| (602) 331-2499 |
| Full Name | Desert Pain And Rehab Specialists |
|---|---|
| Speciality | Physical Medicine & Rehabilitation |
| Location | 11047 N 19th Ave, Phoenix, Arizona |
| Authorized Official Name and Position | Herbert Donald Goodman (CO-OWNER) |
| Authorized Official Contact | 6029442222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Desert Pain And Rehab Specialists 11047 N 19th Ave Phoenix AZ 85029-4816 Ph: (602) 944-2222 | Desert Pain And Rehab Specialists 11047 N 19th Ave Phoenix AZ 85029 Ph: (602) 944-2222 |
| NPI Number | 1457416414 |
|---|---|
| Provider Enumeration Date | 12/27/2006 |
| Last Update Date | 06/24/2019 |
| Medicare PECOS PAC ID | 9133168271 |
|---|---|
| Medicare Enrollment ID | O20050428000513 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457416414 | NPI | - | NPPES |
| 306932 | Medicaid | AZ |
| Provider Name | Herbert D Goodman |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1346258472 PECOS PAC ID: 8325087364 Enrollment ID: I20050429000251 |
| Provider Name | Steven R Edelman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871732727 PECOS PAC ID: 8022169804 Enrollment ID: I20090708000328 |
| Provider Name | Julie A Overbey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730496282 PECOS PAC ID: 1951582071 Enrollment ID: I20110223000286 |
| Provider Name | Daniel J Chow |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1821377607 PECOS PAC ID: 5799958674 Enrollment ID: I20111109000823 |
| Provider Name | Mandy Neblett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063789568 PECOS PAC ID: 9234390568 Enrollment ID: I20120413000344 |
| Provider Name | Roy Lee Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578583209 PECOS PAC ID: 8426108481 Enrollment ID: I20140428000003 |
| Provider Name | Charlene F Baldwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033546411 PECOS PAC ID: 2961628292 Enrollment ID: I20140730002884 |
| Provider Name | Kara A Fishgold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043797905 PECOS PAC ID: 6800148826 Enrollment ID: I20181002002789 |
| Provider Name | Suzanne M Swain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790245678 PECOS PAC ID: 0941533327 Enrollment ID: I20190618001525 |
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