| Modern Vascular Of Mesa, Llc | |
|
535 E Mckellips Rd Ste 111 Mesa AZ 85203 | |
| (480) 223-1333 | |
| Not Available |
| Full Name | Modern Vascular Of Mesa, Llc |
|---|---|
| Speciality | Radiology |
| Location | 535 E Mckellips Rd Ste 111, Mesa, Arizona |
| Authorized Official Name and Position | Tim Murphy (VP OPERATIONS) |
| Authorized Official Contact | 8188808605 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Vascular Of Mesa, Llc 26500 Agoura Rd Ste 102-587 Calabasas CA 91302-1952 Ph: (818) 880-8605 | Modern Vascular Of Mesa, Llc 535 E Mckellips Rd Ste 111 Mesa AZ 85203 Ph: (480) 223-1333 |
| NPI Number | 1427583087 |
|---|---|
| Provider Enumeration Date | 04/20/2017 |
| Last Update Date | 07/11/2018 |
| Medicare PECOS PAC ID | 0446537948 |
|---|---|
| Medicare Enrollment ID | O20170511000409 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427583087 | NPI | - | NPPES |
| Provider Name | Marc L Eckhauser |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1811997513 PECOS PAC ID: 2567362676 Enrollment ID: I20040113000443 |
| Provider Name | Brian W Zernich |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902878895 PECOS PAC ID: 9931091253 Enrollment ID: I20040329001820 |
| Provider Name | Bashar J Markabawi |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1518968429 PECOS PAC ID: 2567457484 Enrollment ID: I20040419001198 |
| Provider Name | Ayman Jamal |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1083600845 PECOS PAC ID: 9436114915 Enrollment ID: I20050927000129 |
| Provider Name | Anthony C Pozun |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1275580755 PECOS PAC ID: 3779586870 Enrollment ID: I20060810000123 |
| Provider Name | Cordell A Esplin |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1619942216 PECOS PAC ID: 6002891447 Enrollment ID: I20080428000285 |
| Provider Name | Wei Jen Sheu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104069392 PECOS PAC ID: 0446306625 Enrollment ID: I20090914000750 |
| Provider Name | Michael C Switzer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639309073 PECOS PAC ID: 1759436967 Enrollment ID: I20100702000245 |
| Provider Name | Mary Grace Leon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295978799 PECOS PAC ID: 8921131855 Enrollment ID: I20100729000399 |
| Provider Name | Drew Hunter |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1649415308 PECOS PAC ID: 7416125562 Enrollment ID: I20110718000071 |
| Provider Name | Scott M Brannan |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1033369707 PECOS PAC ID: 4688866619 Enrollment ID: I20120730000756 |
| Provider Name | Faisal A Bahadur |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1144421355 PECOS PAC ID: 3375699168 Enrollment ID: I20120806000065 |
| Provider Name | Barbara L Hanisch Lucas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023361599 PECOS PAC ID: 9234381336 Enrollment ID: I20121219000291 |
| Provider Name | Elsa Cedillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760840391 PECOS PAC ID: 7113226978 Enrollment ID: I20160428001312 |
| Provider Name | Michelle Gustafson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497126874 PECOS PAC ID: 9739470287 Enrollment ID: I20160614001283 |
| Provider Name | Jacqueline M Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922400811 PECOS PAC ID: 3577885573 Enrollment ID: I20161128001227 |
| Provider Name | Jodi Frances Kirk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164973558 PECOS PAC ID: 1355622374 Enrollment ID: I20170106000992 |
| Provider Name | Kristi Ford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316458508 PECOS PAC ID: 9133485238 Enrollment ID: I20171106002159 |
| Provider Name | Nikhil C Patel |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1053345926 PECOS PAC ID: 7911800487 Enrollment ID: I20180919002131 |
| Provider Name | Jack R Hannallah |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497018915 PECOS PAC ID: 3274898481 Enrollment ID: I20181025001409 |
| Provider Name | Ana Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851860415 PECOS PAC ID: 5092053447 Enrollment ID: I20190211002951 |
| Provider Name | Arthur Maydell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992078745 PECOS PAC ID: 2668784422 Enrollment ID: I20190322002095 |
| Provider Name | Kathrina Lynn Ridley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700358322 PECOS PAC ID: 1052629961 Enrollment ID: I20190402001741 |
| Provider Name | Luis Nadal |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1720041510 PECOS PAC ID: 0547214710 Enrollment ID: I20190731000341 |
| Provider Name | Emma R Nunez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053971796 PECOS PAC ID: 5092045104 Enrollment ID: I20191002001519 |
| Provider Name | Sergei Sobolevsky |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1831154301 PECOS PAC ID: 4183624950 Enrollment ID: I20191011002398 |
| Provider Name | Sanjeev Saxena |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1093701120 PECOS PAC ID: 2769423359 Enrollment ID: I20191022002845 |
| Provider Name | Randy Savageau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548804735 PECOS PAC ID: 1658704234 Enrollment ID: I20191212001915 |
| Provider Name | Walkennia E Simpson-earl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861052094 PECOS PAC ID: 8325472996 Enrollment ID: I20200107002970 |
| Provider Name | Patricia Ellen Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356990774 PECOS PAC ID: 8628406691 Enrollment ID: I20200325002835 |
| Provider Name | Benjamin Scott Wilson |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1821382409 PECOS PAC ID: 6800190315 Enrollment ID: I20200325003435 |
| Provider Name | Babafemi Pratt |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1174773873 PECOS PAC ID: 2365695509 Enrollment ID: I20201020002078 |
| Provider Name | Maria Litzendorf |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1598935058 PECOS PAC ID: 3274696760 Enrollment ID: I20201222001904 |
| Provider Name | Suzzan Tarno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376571778 PECOS PAC ID: 3476582123 Enrollment ID: I20210119002794 |
| Provider Name | Patrick Duffy |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1477726271 PECOS PAC ID: 2264599869 Enrollment ID: I20220330000758 |
| Provider Name | Mamdouh Khayat |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1780941583 PECOS PAC ID: 0840428108 Enrollment ID: I20221028001223 |
| Provider Name | Samuel Putnam |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1023066404 PECOS PAC ID: 5991699522 Enrollment ID: I20221129003181 |
| Provider Name | Paul Rochon |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1598913980 PECOS PAC ID: 5193910875 Enrollment ID: I20221130000799 |
| Provider Name | Alexander Shestopalov |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1053756098 PECOS PAC ID: 5698021756 Enrollment ID: I20221130001905 |
Ohana Kids & Family Kare Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3130 E Baseline Rd Ste 103, Mesa, AZ 85204 Phone: 480-539-7618 Fax: 480-900-8884 | |
True Patriot Consulting, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1134 E University Dr Ste 111, Mesa, AZ 85203 Phone: 480-398-1220 Fax: 480-398-1238 | |
M.g.t Rn Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7117 E Peralta Cir, Mesa, AZ 85212 Phone: 480-430-0721 | |
Stillpoint Wellness, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2266 S Dobson Rd Ste 200, Mesa, AZ 85202 Phone: 480-280-1996 Fax: 602-532-7649 | |
Cactus Pediatric Orthopaedics, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1500 S Dobson Rd Ste 200, Mesa, AZ 85202 Phone: 480-551-0300 | |
Voyage Medical Primary Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1130 W Grove Ave Ste 115, Mesa, AZ 85210 Phone: 480-685-0930 | |
Tripp Family Medicine, P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2830 E Brown Rd, Suite 1, Mesa, AZ 85213 Phone: 480-830-7546 Fax: 480-830-7550 |