| Optum Primary Care | |
|
14418 W Meeker Blvd #210 Sun City West AZ 85375-5291 | |
| (623) 544-8400 | |
| (623) 544-8989 |
| Full Name | Optum Primary Care |
|---|---|
| Speciality | Internal Medicine |
| Location | 14418 W Meeker Blvd, Sun City West, Arizona |
| Authorized Official Name and Position | Emily Castillo (REGIONAL MANAGER) |
| Authorized Official Contact | 7024802550 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Optum Primary Care 14418 W Meeker Blvd Suite 210 Sun City West AZ 85375-5291 Ph: (623) 544-8400 | Optum Primary Care 14418 W Meeker Blvd #210 Sun City West AZ 85375-5291 Ph: (623) 544-8400 |
| NPI Number | 1689818874 |
|---|---|
| Provider Enumeration Date | 05/01/2009 |
| Last Update Date | 09/02/2023 |
| Medicare PECOS PAC ID | 4082751714 |
|---|---|
| Medicare Enrollment ID | O20091028000476 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689818874 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 25355 (Arizona) | Primary |
| Provider Name | Jalal M Abbas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205895034 PECOS PAC ID: 2769463009 Enrollment ID: I20040525000204 |
| Provider Name | Dilip C Dhadvai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497861181 PECOS PAC ID: 6406881200 Enrollment ID: I20050929001254 |
| Provider Name | Kishor D Mehta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609878263 PECOS PAC ID: 0547284861 Enrollment ID: I20081014000059 |
| Provider Name | Rommel Paulo P Mesola |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104979269 PECOS PAC ID: 8426156993 Enrollment ID: I20151203001382 |
| Provider Name | Roxane Marie Jueckstock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780044842 PECOS PAC ID: 3870868227 Enrollment ID: I20171023002103 |
| Provider Name | Theresa Krueger-junk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225400500 PECOS PAC ID: 4082918198 Enrollment ID: I20210804003301 |
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