| Infinity Medical Providers | |
|
350 E Eva St Phoenix AZ 85020-2564 | |
| (773) 410-1676 | |
| Not Available |
| Full Name | Infinity Medical Providers |
|---|---|
| Speciality | Family Medicine |
| Location | 350 E Eva St, Phoenix, Arizona |
| Authorized Official Name and Position | Kareem Mccleskey (ADMINISTRATOR) |
| Authorized Official Contact | 6026994066 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Infinity Medical Providers 21001 N Tatum Blvd Ste 1630 Box 941 Phoenix AZ 85050-4242 Ph: (602) 699-4066 | Infinity Medical Providers 350 E Eva St Phoenix AZ 85020-2564 Ph: (773) 410-1676 |
| NPI Number | 1154957678 |
|---|---|
| Provider Enumeration Date | 03/16/2020 |
| Last Update Date | 01/19/2023 |
| Medicare PECOS PAC ID | 6002246006 |
|---|---|
| Medicare Enrollment ID | O20200414003938 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154957678 | NPI | - | NPPES |
| 004822 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Aashish Sagar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083607816 PECOS PAC ID: 5890759799 Enrollment ID: I20041118001002 |
| Provider Name | Nicole Kay Larsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265918726 PECOS PAC ID: 5193065910 Enrollment ID: I20190314000187 |
| Provider Name | Dawna R Hernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295340651 PECOS PAC ID: 8820418361 Enrollment ID: I20201021002220 |
| Provider Name | Emetu Onuma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003424771 PECOS PAC ID: 7012397821 Enrollment ID: I20220711000084 |
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