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6544 W Thomas Rd Ste 11 Phoenix AZ 85033-5740 | |
| (602) 834-5515 | |
| (877) 536-8279 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 6544 W Thomas Rd Ste 11, Phoenix, Arizona |
| Authorized Official Name and Position | Angie Martinez (SENIOR CREDENTIALING PROFESSIONAL) |
| Authorized Official Contact | 4074477120 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
6101 Blue Lagoon Dr Ste 200 Miami FL 33126-3168 Ph: (305) 500-2000 | 6544 W Thomas Rd Ste 11 Phoenix AZ 85033-5740 Ph: (602) 834-5515 |
| NPI Number | 1073260352 |
|---|---|
| Provider Enumeration Date | 03/07/2022 |
| Last Update Date | 08/19/2024 |
| Medicare PECOS PAC ID | 9830576354 |
|---|---|
| Medicare Enrollment ID | O20220521000136 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073260352 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| Provider Name | Nestor N Nazareno |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386617629 PECOS PAC ID: 2860487303 Enrollment ID: I20050608000969 |
| Provider Name | Satpreet Singh Gill |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750487344 PECOS PAC ID: 3779503339 Enrollment ID: I20051129000384 |
| Provider Name | Richard Wolfson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497712475 PECOS PAC ID: 9537189873 Enrollment ID: I20051130000950 |
| Provider Name | Herminia G Herrera-tan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295812774 PECOS PAC ID: 6002919875 Enrollment ID: I20070315000233 |
| Provider Name | Ravinder R Dawke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275730780 PECOS PAC ID: 0042302028 Enrollment ID: I20070822000820 |
| Provider Name | Sanjay S Bommakanti |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114111002 PECOS PAC ID: 9335233063 Enrollment ID: I20070925000628 |
| Provider Name | Maria J Hoertz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104871607 PECOS PAC ID: 7315830601 Enrollment ID: I20080304000376 |
| Provider Name | Christine L Armenta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972752509 PECOS PAC ID: 3173674496 Enrollment ID: I20090626000467 |
| Provider Name | Antonio V Yu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770564171 PECOS PAC ID: 1951306703 Enrollment ID: I20100831000656 |
| Provider Name | Benedict B Dayrit |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376617464 PECOS PAC ID: 8426040734 Enrollment ID: I20101022000322 |
| Provider Name | Vidya Raman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508810326 PECOS PAC ID: 6204020829 Enrollment ID: I20101027001428 |
| Provider Name | Maria T Reyes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467526558 PECOS PAC ID: 7416949722 Enrollment ID: I20101103001271 |
| Provider Name | Dorin T Popa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568621795 PECOS PAC ID: 8426228123 Enrollment ID: I20110908001633 |
| Provider Name | Sharleen V Ballance |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235579079 PECOS PAC ID: 5799928404 Enrollment ID: I20130828000661 |
| Provider Name | Prabhdeep Sandhu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831543883 PECOS PAC ID: 4385913482 Enrollment ID: I20170705003025 |
| Provider Name | Sahar S Zuberi |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1407291750 PECOS PAC ID: 2163748286 Enrollment ID: I20171013001026 |
| Provider Name | Leslee Hamadeh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144728130 PECOS PAC ID: 3678835782 Enrollment ID: I20180328003071 |
| Provider Name | Ajitha Nair |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558801522 PECOS PAC ID: 8729347802 Enrollment ID: I20181016001752 |
| Provider Name | Sherry Lynn Montoya-velasquez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366911059 PECOS PAC ID: 7214275080 Enrollment ID: I20190221000290 |
| Provider Name | Neal Patrick Patalinghug |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588697544 PECOS PAC ID: 6507996766 Enrollment ID: I20190417002849 |
| Provider Name | Sabrina C Ramirez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578031506 PECOS PAC ID: 0749515328 Enrollment ID: I20190718002725 |
| Provider Name | Guen Cecilia Tawagon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609415744 PECOS PAC ID: 5294161550 Enrollment ID: I20200204002443 |
| Provider Name | Aaron T Saunders |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902148208 PECOS PAC ID: 7113288895 Enrollment ID: I20201014001050 |
| Provider Name | Daniel E Isaac |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528564564 PECOS PAC ID: 7012313232 Enrollment ID: I20210913002952 |
| Provider Name | Thihalolipavan Sayalolipavan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053309039 PECOS PAC ID: 6709843600 Enrollment ID: I20220701000557 |
| Provider Name | John C Stanton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952806267 PECOS PAC ID: 9638577752 Enrollment ID: I20221026001537 |
| Provider Name | Ashley Noel Olson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003486085 PECOS PAC ID: 9234501230 Enrollment ID: I20230220001476 |
| Provider Name | Vanessa Porras |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902505647 PECOS PAC ID: 2163897844 Enrollment ID: I20230411001893 |
| Provider Name | Diana I Elizalde |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922661032 PECOS PAC ID: 8022342773 Enrollment ID: I20230614002803 |
| Provider Name | Jayshree Arun Kumar Bhaskara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790771228 PECOS PAC ID: 9638265622 Enrollment ID: I20230703002554 |
| Provider Name | Weston Krauss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154942068 PECOS PAC ID: 3274994736 Enrollment ID: I20241010003120 |
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