Archwell Health Professional Services Of Arizona, Llc | |
4315 E Main St Mesa AZ 85205-8605 | |
(888) 987-1151 | |
Not Available |
Full Name | Archwell Health Professional Services Of Arizona, Llc |
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Speciality | Internal Medicine |
Location | 4315 E Main St, Mesa, Arizona |
Authorized Official Name and Position | Lisa Lucas (CHIEF ADMINISTRATIVE OFFICER) |
Authorized Official Contact | 6154199047 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Archwell Health Professional Services Of Arizona, Llc 102 Woodmont Blvd Ste 600 Nashville TN 37205-5250 Ph: () - | Archwell Health Professional Services Of Arizona, Llc 4315 E Main St Mesa AZ 85205-8605 Ph: (888) 987-1151 |
NPI Number | 1558026880 |
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Provider Enumeration Date | 11/02/2021 |
Last Update Date | 04/05/2023 |
Medicare PECOS PAC ID | 9830566199 |
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Medicare Enrollment ID | O20221031001469 |
Identifier | Type | State | Issuer |
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1558026880 | NPI | - | NPPES |
Provider Name | Dana M Kageyama |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1629034566 PECOS PAC ID: 1557310315 Enrollment ID: I20050119000347 |
Provider Name | Jay G Bernstein |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1649233396 PECOS PAC ID: 6800836818 Enrollment ID: I20050510000320 |
Provider Name | Mark C Luba |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1437139813 PECOS PAC ID: 4284668260 Enrollment ID: I20050920000280 |
Provider Name | Parwin S Sadaat |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1487695243 PECOS PAC ID: 1759308935 Enrollment ID: I20060323000806 |
Provider Name | Lori B Burke |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699975508 PECOS PAC ID: 1052408465 Enrollment ID: I20071101000398 |
Provider Name | Michael A Herrera |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1871610774 PECOS PAC ID: 5799850483 Enrollment ID: I20080814000358 |
Provider Name | Kim Susanne Morris |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1962464206 PECOS PAC ID: 0345309704 Enrollment ID: I20081030000555 |
Provider Name | Lisa L Fuller |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1366567398 PECOS PAC ID: 8729052055 Enrollment ID: I20090921000559 |
Provider Name | Leonardo C Serfino |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1831114743 PECOS PAC ID: 4587704499 Enrollment ID: I20091224000041 |
Provider Name | Nasrin Jazayeri |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083776785 PECOS PAC ID: 5991805749 Enrollment ID: I20100115000008 |
Provider Name | Maria E Gonzalez Berlari |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1861665796 PECOS PAC ID: 3577606128 Enrollment ID: I20100204000067 |
Provider Name | Iram H Khan |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1740487719 PECOS PAC ID: 9739204041 Enrollment ID: I20100909001039 |
Provider Name | Glenda G Williams |
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Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1639379605 PECOS PAC ID: 3577713858 Enrollment ID: I20121023000050 |
Provider Name | Bharat Nepal |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1861809618 PECOS PAC ID: 8426274945 Enrollment ID: I20140718000977 |
Provider Name | Sonia M Bertram |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043637424 PECOS PAC ID: 4385964436 Enrollment ID: I20150513002007 |
Provider Name | Kelly Woodrow |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1447632195 PECOS PAC ID: 3072821990 Enrollment ID: I20150925002333 |
Provider Name | Norma Ann Bracamonte |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1851757603 PECOS PAC ID: 7911200613 Enrollment ID: I20160128002572 |
Provider Name | Chinwe N Chukwurah |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1467637140 PECOS PAC ID: 9537244413 Enrollment ID: I20160519000538 |
Provider Name | Christina Marie Johansen |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1912366279 PECOS PAC ID: 3476843665 Enrollment ID: I20160531001553 |
Provider Name | Carrie Church |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1790231546 PECOS PAC ID: 9931476967 Enrollment ID: I20170523002387 |
Provider Name | Rebecca Maree Hoover |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457851826 PECOS PAC ID: 7113270414 Enrollment ID: I20181105000299 |
Provider Name | Anna L Bell |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1427528686 PECOS PAC ID: 7315287182 Enrollment ID: I20190314002065 |
Provider Name | Alessandra L Clark |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1942681143 PECOS PAC ID: 1850648775 Enrollment ID: I20190319000431 |
Provider Name | Kirstin Knobbe Lloyd |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1548615644 PECOS PAC ID: 3476827775 Enrollment ID: I20190327000349 |
Provider Name | Ayin Daleth Hernandez |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1619433489 PECOS PAC ID: 3476886888 Enrollment ID: I20190617002309 |
Provider Name | Roel Conrad Jamis |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1033419429 PECOS PAC ID: 7911138144 Enrollment ID: I20190714000014 |
Provider Name | Leigh Anne Costanzo |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1932563392 PECOS PAC ID: 3971899246 Enrollment ID: I20190717003134 |
Provider Name | Sonja Jw Cruz |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1558719955 PECOS PAC ID: 9234426750 Enrollment ID: I20190801002779 |
Provider Name | Shana J Bean |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538709761 PECOS PAC ID: 7214363290 Enrollment ID: I20200211001702 |
Provider Name | Linda L Johnson |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1033182522 PECOS PAC ID: 9335109149 Enrollment ID: I20200901001523 |
Provider Name | Elena Aminov |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1992301923 PECOS PAC ID: 4688087331 Enrollment ID: I20210119002423 |
Provider Name | Melinda Jones-saah |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477078798 PECOS PAC ID: 2062778061 Enrollment ID: I20220218001745 |
Provider Name | Lin Clark |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1396830477 PECOS PAC ID: 2163414129 Enrollment ID: I20220408001251 |
Provider Name | Antenor Xavier Aviles |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1528668720 PECOS PAC ID: 9032508569 Enrollment ID: I20220713002296 |
Provider Name | Michelle Jennings |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1104334077 PECOS PAC ID: 7810259488 Enrollment ID: I20220922002173 |
Provider Name | Marisela F Mariscal |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1063075836 PECOS PAC ID: 0042545493 Enrollment ID: I20221006001513 |
Provider Name | Lauren E Maxham |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1326347154 PECOS PAC ID: 1951521582 Enrollment ID: I20221206001737 |
Provider Name | Jennifer Winthers |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1568895415 PECOS PAC ID: 7810288214 Enrollment ID: I20221216000484 |
Provider Name | Ranilo Limcaoco Asuncion |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1639122815 PECOS PAC ID: 6305731209 Enrollment ID: I20230123001365 |
Provider Name | Sameera Ray |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1568199826 PECOS PAC ID: 0345611570 Enrollment ID: I20230125001798 |
Provider Name | Jacob Vanhouten |
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Provider Type | Practitioner - Preventive Medicine |
Provider Identifiers | NPI Number: 1821595083 PECOS PAC ID: 3173900727 Enrollment ID: I20230126000482 |
Provider Name | Zachary Logan |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1538521620 PECOS PAC ID: 9537431051 Enrollment ID: I20230127000480 |
Provider Name | Cora Lynn Tompkins |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1295892305 PECOS PAC ID: 9638130875 Enrollment ID: I20230127001083 |
Provider Name | Monica C Reyes |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477218600 PECOS PAC ID: 7214308394 Enrollment ID: I20230127001964 |
Provider Name | Sheryl S Allred |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386697449 PECOS PAC ID: 6608247572 Enrollment ID: I20230201001486 |
Provider Name | Tesha Marie Hopphaus |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1588385884 PECOS PAC ID: 3678945235 Enrollment ID: I20230207002865 |
Provider Name | Karina M Bailey |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699408492 PECOS PAC ID: 4183096399 Enrollment ID: I20230217000243 |
Provider Name | Judith Ford |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1164495206 PECOS PAC ID: 7416029491 Enrollment ID: I20231020002302 |
Provider Name | Anna Sokolowski |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1598057200 PECOS PAC ID: 3678890811 Enrollment ID: I20240313004351 |
Provider Name | Trevan R Sedlak |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1033470844 PECOS PAC ID: 3476859380 Enrollment ID: I20240328003191 |
Provider Name | Manuel Reyes |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1245281708 PECOS PAC ID: 1658412507 Enrollment ID: I20240401002756 |
Provider Name | Kinal Patel |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1063862480 PECOS PAC ID: 7719278894 Enrollment ID: I20240412003594 |
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