Bluesky Family Medicine | |
2401 W Glendale Ave Ste 203 Phoenix AZ 85021-7677 | |
(602) 772-5770 | |
(602) 772-5771 |
Full Name | Bluesky Family Medicine |
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Speciality | Psychiatry & Neurology |
Location | 2401 W Glendale Ave Ste 203, Phoenix, Arizona |
Authorized Official Name and Position | Sumaira Doorani (MANAGER) |
Authorized Official Contact | 6027725770 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Bluesky Family Medicine 2401 W Glendale Ave Ste 203 Phoenix AZ 85021-7677 Ph: (602) 772-5770 | Bluesky Family Medicine 2401 W Glendale Ave Ste 203 Phoenix AZ 85021-7677 Ph: (602) 772-5770 |
NPI Number | 1104122621 |
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Provider Enumeration Date | 01/31/2011 |
Last Update Date | 04/23/2019 |
Medicare PECOS PAC ID | 9436330701 |
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Medicare Enrollment ID | O20110218000603 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104122621 | NPI | - | NPPES |
Z143146 | Other | AZ | PTAN |
8293938 | Medicaid | WA |
Provider Name | Tariq Doorani |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1740240027 PECOS PAC ID: 8527118538 Enrollment ID: I20090615000042 |
Provider Name | Patrick Michael Donnelly |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083786040 PECOS PAC ID: 6800042235 Enrollment ID: I20181008001574 |
Provider Name | Kerstin Mcelvain |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1508320706 PECOS PAC ID: 1355504663 Enrollment ID: I20190306000921 |
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