| Alante Primary Care Llc | |
|
8502 E Princess Dr Ste 200e Scottsdale AZ 85255-7802 | |
| (480) 631-4978 | |
| (844) 443-4378 |
| Full Name | Alante Primary Care Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8502 E Princess Dr Ste 200e, Scottsdale, Arizona |
| Authorized Official Name and Position | Jacob Schaefer (EXECUTIVE VICE PRESIDENT) |
| Authorized Official Contact | 5032018356 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alante Primary Care Llc 8502 E Princess Dr Ste 200e Scottsdale AZ 85255-7802 Ph: (480) 563-2402 | Alante Primary Care Llc 8502 E Princess Dr Ste 200e Scottsdale AZ 85255-7802 Ph: (480) 631-4978 |
| NPI Number | 1700468527 |
|---|---|
| Provider Enumeration Date | 04/21/2021 |
| Last Update Date | 07/01/2024 |
| Medicare PECOS PAC ID | 4183016769 |
|---|---|
| Medicare Enrollment ID | O20220111000774 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700468527 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| 363LP2300X | Nurse Practitioner - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Christina L Summers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821319872 PECOS PAC ID: 7113101098 Enrollment ID: I20110419000057 |
| Provider Name | Mehran Darzy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225370695 PECOS PAC ID: 1759528763 Enrollment ID: I20130511000065 |
| Provider Name | Judith A Abell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003916990 PECOS PAC ID: 4284802067 Enrollment ID: I20150529001971 |
| Provider Name | Michelle M Vidaure |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114312006 PECOS PAC ID: 9335451384 Enrollment ID: I20150702002166 |
| Provider Name | Wisam F Shaba |
|---|---|
| Provider Type | Practitioner - Nuclear Medicine |
| Provider Identifiers | NPI Number: 1366712176 PECOS PAC ID: 8022319342 Enrollment ID: I20151210001262 |
| Provider Name | Tandra Arlene Garvin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881140259 PECOS PAC ID: 7214217181 Enrollment ID: I20161212000602 |
| Provider Name | Caitlyn Procopio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497233217 PECOS PAC ID: 0648514034 Enrollment ID: I20181212001908 |
| Provider Name | Courtney Celeste Cyphers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356822944 PECOS PAC ID: 7618216664 Enrollment ID: I20190308001529 |
| Provider Name | Amber Brasfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568000990 PECOS PAC ID: 6507293362 Enrollment ID: I20200218000275 |
| Provider Name | Lauren Zimmerman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225625940 PECOS PAC ID: 0244647261 Enrollment ID: I20210318000985 |
| Provider Name | Kristin V Olson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477155018 PECOS PAC ID: 5395147417 Enrollment ID: I20210713000849 |
| Provider Name | Jismi Theeyattuveli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285229534 PECOS PAC ID: 0446655625 Enrollment ID: I20210826000869 |
| Provider Name | Maria Pamela Medida |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487322418 PECOS PAC ID: 5193117893 Enrollment ID: I20220107002356 |
| Provider Name | Funmilayo Oluwole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780115345 PECOS PAC ID: 1759650468 Enrollment ID: I20220826000542 |
| Provider Name | Geoffrey Figueras Medida |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659080067 PECOS PAC ID: 5597134569 Enrollment ID: I20221214000432 |
| Provider Name | Sydney Thomson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336828912 PECOS PAC ID: 6204278583 Enrollment ID: I20240531003066 |
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