| Advanced Telemedicine Associates Llc | |
|
3195 Saint Rose Pkwy Ste 212 Henderson NV 89052-3504 | |
| (702) 468-5905 | |
| Not Available |
| Full Name | Advanced Telemedicine Associates Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3195 Saint Rose Pkwy Ste 212, Henderson, Nevada |
| Authorized Official Name and Position | Edward Makarewicz (CEO) |
| Authorized Official Contact | 5754966142 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Telemedicine Associates Llc 2654 W Horizon Ridge Pkwy Ste B5214 Henderson NV 89052-2803 Ph: (702) 468-5905 | Advanced Telemedicine Associates Llc 3195 Saint Rose Pkwy Ste 212 Henderson NV 89052-3504 Ph: (702) 468-5905 |
| NPI Number | 1376130963 |
|---|---|
| Provider Enumeration Date | 12/29/2020 |
| Last Update Date | 12/21/2023 |
| Medicare PECOS PAC ID | 0840651345 |
|---|---|
| Medicare Enrollment ID | O20230801000061 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376130963 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Edward Makarewicz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093057200 PECOS PAC ID: 4880916956 Enrollment ID: I20160721002699 |
| Provider Name | Haider Alhaidari |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1639563083 PECOS PAC ID: 2062728116 Enrollment ID: I20190328002967 |
| Provider Name | Susil Sivaraman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437577327 PECOS PAC ID: 0840419982 Enrollment ID: I20190712000364 |
| Provider Name | Shaista Shiraz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750099925 PECOS PAC ID: 5698146868 Enrollment ID: I20240828001155 |
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