| Banner - University Super Specialists Llc | |
|
1111 E Mcdowell Rd Phoenix AZ 85006-2612 | |
| (602) 839-2000 | |
| Not Available |
| Full Name | Banner - University Super Specialists Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1111 E Mcdowell Rd, Phoenix, Arizona |
| Authorized Official Name and Position | Venkata Evani (BUMG CEO) |
| Authorized Official Contact | 6025215935 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Banner - University Super Specialists Llc 2901 N Central Ave Ste 160 Phoenix AZ 85012-2702 Ph: () - | Banner - University Super Specialists Llc 1111 E Mcdowell Rd Phoenix AZ 85006-2612 Ph: (602) 839-2000 |
| NPI Number | 1740650555 |
|---|---|
| Provider Enumeration Date | 10/06/2015 |
| Last Update Date | 03/17/2023 |
| Medicare PECOS PAC ID | 1850695255 |
|---|---|
| Medicare Enrollment ID | O20160204002443 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740650555 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Edgardo R Laurel |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1992708788 PECOS PAC ID: 9830160878 Enrollment ID: I20040804000101 |
| Provider Name | Mark N Wong |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1821054081 PECOS PAC ID: 9436121316 Enrollment ID: I20040811000294 |
| Provider Name | Richard Sue |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1053320168 PECOS PAC ID: 5991772063 Enrollment ID: I20040916000999 |
| Provider Name | Rajiv D Poduval |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1205822749 PECOS PAC ID: 3072562511 Enrollment ID: I20050121000482 |
| Provider Name | Amandeep S Khurana |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1508852716 PECOS PAC ID: 5294765509 Enrollment ID: I20050816001215 |
| Provider Name | Alejandro Morales |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1134192909 PECOS PAC ID: 1759353592 Enrollment ID: I20060316000121 |
| Provider Name | Romanita D Nica |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1366486144 PECOS PAC ID: 9335159151 Enrollment ID: I20060425000039 |
| Provider Name | Harvey Hsu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659330769 PECOS PAC ID: 4486665569 Enrollment ID: I20060606000261 |
| Provider Name | Alberto X Ramos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487788998 PECOS PAC ID: 0446341408 Enrollment ID: I20070806000068 |
| Provider Name | Megan Dixon |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1689868416 PECOS PAC ID: 2264506146 Enrollment ID: I20080812000030 |
| Provider Name | Ibrahim Qaqish |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1740462431 PECOS PAC ID: 7012084023 Enrollment ID: I20080917000198 |
| Provider Name | Luz O Pelayo-katsanis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306094008 PECOS PAC ID: 2466520440 Enrollment ID: I20081003000342 |
| Provider Name | Kenneth S Knox |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1154386118 PECOS PAC ID: 4981761137 Enrollment ID: I20090316000414 |
| Provider Name | Erin K Ferguson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649437617 PECOS PAC ID: 6002962495 Enrollment ID: I20091016000227 |
| Provider Name | Stephen M Schinker |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1134304173 PECOS PAC ID: 9032285507 Enrollment ID: I20100712000305 |
| Provider Name | Nicholette L Breier Adkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518286210 PECOS PAC ID: 0042335853 Enrollment ID: I20100916001298 |
| Provider Name | Lucille K Mcelrath |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801114269 PECOS PAC ID: 6305025578 Enrollment ID: I20110120000932 |
| Provider Name | Vidette Villareal Argente |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033413125 PECOS PAC ID: 2062693195 Enrollment ID: I20110223000380 |
| Provider Name | Shoma Bommena |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952610966 PECOS PAC ID: 4183866270 Enrollment ID: I20130820001009 |
| Provider Name | Lauren Sapp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982955415 PECOS PAC ID: 9032346523 Enrollment ID: I20131206001470 |
| Provider Name | Gerard C Quigley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881030781 PECOS PAC ID: 3870721129 Enrollment ID: I20140625002104 |
| Provider Name | Jorida Lulaj |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679973911 PECOS PAC ID: 5698993871 Enrollment ID: I20140829001804 |
| Provider Name | Jennifer L Grindler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811392475 PECOS PAC ID: 9739403353 Enrollment ID: I20150130000002 |
| Provider Name | Rachel L Armenta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801287354 PECOS PAC ID: 1254658867 Enrollment ID: I20150319001015 |
| Provider Name | Shefali Gupta |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1902927981 PECOS PAC ID: 0143315556 Enrollment ID: I20150623002931 |
| Provider Name | Ramachandra R Sista |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1083740252 PECOS PAC ID: 8628095551 Enrollment ID: I20150701001476 |
| Provider Name | Jana M Montez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770950438 PECOS PAC ID: 4688982960 Enrollment ID: I20151006002784 |
| Provider Name | David Y Moromisato |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386771707 PECOS PAC ID: 0042346322 Enrollment ID: I20160209002592 |
| Provider Name | Minesh Rajpal |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1568760502 PECOS PAC ID: 7315231503 Enrollment ID: I20160810002863 |
| Provider Name | Michael B Fallon |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1629163613 PECOS PAC ID: 0446313662 Enrollment ID: I20161025002568 |
| Provider Name | Santosh S Hanmod |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1730337478 PECOS PAC ID: 9335462811 Enrollment ID: I20161128001905 |
| Provider Name | Naresh Reddivalla |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1073851150 PECOS PAC ID: 8628367711 Enrollment ID: I20170718001431 |
| Provider Name | Michelina C De La Maza |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255779385 PECOS PAC ID: 7012280852 Enrollment ID: I20170830001672 |
| Provider Name | Heather Ann Fett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811423262 PECOS PAC ID: 5193099802 Enrollment ID: I20170919003316 |
| Provider Name | Jen Jung Pan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1811073166 PECOS PAC ID: 0345386587 Enrollment ID: I20171003006326 |
| Provider Name | Megan Marie A Flores |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1699288639 PECOS PAC ID: 0244591162 Enrollment ID: I20180309000641 |
| Provider Name | Dina M Gibson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063998912 PECOS PAC ID: 1557611902 Enrollment ID: I20180905001679 |
| Provider Name | Rashmi Kumar |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1396007068 PECOS PAC ID: 0941579528 Enrollment ID: I20180905003016 |
| Provider Name | Holly Elizabeth Pariury |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1508129156 PECOS PAC ID: 4587915863 Enrollment ID: I20180926000143 |
| Provider Name | Aravind Sugumar |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1124222716 PECOS PAC ID: 1153408075 Enrollment ID: I20190109000915 |
| Provider Name | Pablo Andres Angulo |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1902122120 PECOS PAC ID: 1658660790 Enrollment ID: I20190222002572 |
| Provider Name | Scott Alan Tomlinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326512203 PECOS PAC ID: 6305186479 Enrollment ID: I20190327002829 |
| Provider Name | Brandon S Gardner |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1770979627 PECOS PAC ID: 9335482595 Enrollment ID: I20190510001478 |
| Provider Name | Monica Margaret Davini |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1952643348 PECOS PAC ID: 8123355237 Enrollment ID: I20190813001269 |
| Provider Name | Misty Villar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831742618 PECOS PAC ID: 2961731526 Enrollment ID: I20190906000756 |
| Provider Name | Suman S Misra |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1023470879 PECOS PAC ID: 6709116775 Enrollment ID: I20190918002350 |
| Provider Name | Joseph Torkildson |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1710944095 PECOS PAC ID: 7911959499 Enrollment ID: I20190919000152 |
| Provider Name | Rohit Nathan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528321437 PECOS PAC ID: 6709192347 Enrollment ID: I20190923001303 |
| Provider Name | Emmanuel Katsanis |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1720053291 PECOS PAC ID: 2264539121 Enrollment ID: I20191231000481 |
| Provider Name | Laurel Christine Truscott |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1730421579 PECOS PAC ID: 7911271267 Enrollment ID: I20200323001179 |
| Provider Name | Tracey Escalante |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669012084 PECOS PAC ID: 8123459930 Enrollment ID: I20200512000584 |
| Provider Name | Winnie Stuempfle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407448046 PECOS PAC ID: 1456767623 Enrollment ID: I20210312001504 |
| Provider Name | Rajan None Kapoor |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1376881177 PECOS PAC ID: 3971727488 Enrollment ID: I20210518000607 |
| Provider Name | Samer H Bani Hani |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1700086550 PECOS PAC ID: 3072757020 Enrollment ID: I20210527001513 |
| Provider Name | Saed Sulaiman Mohd Nemr |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1992892772 PECOS PAC ID: 4385799097 Enrollment ID: I20210716000333 |
| Provider Name | Kevin Liu |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1831517671 PECOS PAC ID: 0941560171 Enrollment ID: I20210825003069 |
| Provider Name | Juhi Jain |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1447644430 PECOS PAC ID: 8820497803 Enrollment ID: I20210827002230 |
| Provider Name | Ma Ai Thanda Han |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1114202579 PECOS PAC ID: 4284967852 Enrollment ID: I20210915000944 |
| Provider Name | Moises Nevah Rubin |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1841482429 PECOS PAC ID: 7113011552 Enrollment ID: I20211006001370 |
| Provider Name | Katrina Zwack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942870472 PECOS PAC ID: 3476942798 Enrollment ID: I20211108001284 |
| Provider Name | Kenneth Bodziak |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1699790295 PECOS PAC ID: 2961392246 Enrollment ID: I20211129001467 |
| Provider Name | Lindsey Renteria |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033784095 PECOS PAC ID: 3678963949 Enrollment ID: I20211130001321 |
| Provider Name | Karn Wijarnpreecha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942683008 PECOS PAC ID: 9335449495 Enrollment ID: I20220329002556 |
| Provider Name | Leandra Marie Mccutcheon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619586203 PECOS PAC ID: 5698153070 Enrollment ID: I20220526001729 |
| Provider Name | Sakolwan Suchartlikitwong |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1790136471 PECOS PAC ID: 1557653565 Enrollment ID: I20220609001356 |
| Provider Name | Olivia Betty Aranda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164151858 PECOS PAC ID: 5698158046 Enrollment ID: I20220817001693 |
| Provider Name | Amit Rajaram |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1003341876 PECOS PAC ID: 4981969821 Enrollment ID: I20230523001193 |
| Provider Name | Sharon Mary Arthur Doherty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194507640 PECOS PAC ID: 1850741372 Enrollment ID: I20231226001410 |
| Provider Name | Angela Marie Olson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639854763 PECOS PAC ID: 7810348547 Enrollment ID: I20240108003142 |
| Provider Name | Briane Jeniene Mape |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083493142 PECOS PAC ID: 7719339829 Enrollment ID: I20240113000329 |
Richard A. Snider, Md, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12010 S Warner Elliot Loop, Phoenix, AZ 85044 Phone: 480-893-2644 | |
Kelly H. Roy, Md, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1008 E Mcdowell Rd, Phoenix, AZ 85006 Phone: 602-358-8588 Fax: 602-688-6991 | |
My Family Doctor In The Valley Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11030 N Tatum Blvd, Ste 101, Phoenix, AZ 85028 Phone: 602-687-8265 | |
Deborah L Dykema Do Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 20045 N 19th Ave Bldg 9-151, Phoenix, AZ 85027 Phone: 602-978-1555 | |
Scottsdale Housecall Physicians, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11030 N Tatum Blvd Ste 101, Phoenix, AZ 85028 Phone: 602-687-8265 | |
Wings Of Hope Medical Services, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11022 N 28th Dr Ste 205, Phoenix, AZ 85029 Phone: 602-971-0304 Fax: 602-971-0305 | |
Sheperd Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9150 W Indian School Rd Ste 111b, Phoenix, AZ 85037 Phone: 623-247-2300 Fax: 623-247-1939 |