Black Diamond Medical Llc in Peoria, AZ - Medicare Nurse Practitioner

Black Diamond Medical Llc is a medicare enrolled primary clinic (Nurse Practitioner - Primary Care) in Peoria, Arizona. The current practice location for Black Diamond Medical Llc is 20449 N Lake Pleasant Rd Ste 101, Peoria, Arizona. For appointments, you can reach them via phone at (623) 322-0099. The mailing address for Black Diamond Medical Llc is 20449 N Lake Pleasant Rd Ste 101, Peoria, Arizona and phone number is (623) 322-0099.

Black Diamond Medical Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1639644909. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (623) 322-0099.

Contact Information

	Black Diamond Medical Llc
	20449 N Lake Pleasant Rd Ste 101 Peoria AZ 85382-2707
	(623) 322-0099
	Not Available

Map and Direction

Primary Care Clinic Profile

Full Name	Black Diamond Medical Llc
Speciality	Nurse Practitioner
Location	20449 N Lake Pleasant Rd Ste 101, Peoria, Arizona
Authorized Official Name and Position	Tonia Lanette Graham (CO-OWNER)
Authorized Official Contact	6233220099
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Black Diamond Medical Llc 20449 N Lake Pleasant Rd Ste 101 Peoria AZ 85382-2707 Ph: (623) 322-0099	Black Diamond Medical Llc 20449 N Lake Pleasant Rd Ste 101 Peoria AZ 85382-2707 Ph: (623) 322-0099

NPI Details:

NPI Number	1639644909
Provider Enumeration Date	10/12/2018
Last Update Date	03/06/2020

Medicare PECOS Information:

Medicare PECOS PAC ID	4688911811
Medicare Enrollment ID	O20190125003095

Medical Identifiers

Medical identifiers for Black Diamond Medical Llc such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1639644909	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	(* (Not Available))	Secondary
261QU0200X	Clinic/center - Urgent Care	(* (Not Available))	Secondary
363LP2300X	Nurse Practitioner - Primary Care	(* (Not Available))	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Black Diamond Medical Llc acts as a billing entity for following providers:

Provider Name	Tonia L Graham
Provider Type	Practitioner - Nurse Practitioner
Provider Identifiers	NPI Number: 1699108621 PECOS PAC ID: 9133354319 Enrollment ID: I20131023001831

Reviews and Comments

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Black Diamond Medical Llc - Medicare Primary Care in Peoria, AZ