- Medicare Primary Care in Surprise, AZ

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is a medicare enrolled primary clinic (Clinic/center - Multi-specialty) in Surprise, Arizona. The current practice location for is 12361 W Bola Dr, Ste 109, Surprise, Arizona. For appointments, you can reach them via phone at (623) 227-1000. The mailing address for is 12361 W Bola Dr Ste 109, Surprise, Arizona and phone number is (623) 227-1000.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1598125791. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (623) 227-1000.

Contact Information

12361 W Bola Dr
Ste 109
Surprise
AZ 85378-9021
(623) 227-1000
(623) 227-2000

Map and Direction


Primary Care Clinic Profile

Full Name
SpecialityClinic/Center
Location12361 W Bola Dr, Surprise, Arizona
Authorized Official Name and PositionHaresh Boghara (OWNER)
Authorized Official Contact2142502140
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address

12361 W Bola Dr Ste 109
Surprise
AZ 85378-9021

Ph: (623) 227-1000
12361 W Bola Dr
Ste 109
Surprise
AZ 85378-9021

Ph: (623) 227-1000

NPI Details:

NPI Number1598125791
Provider Enumeration Date03/01/2016
Last Update Date07/01/2024

Medicare PECOS Information:

Medicare PECOS PAC ID2466709274
Medicare Enrollment IDO20180725002648

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1598125791NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine (* (Not Available))Secondary
208000000XPediatrics (* (Not Available))Secondary
2084N0400XPsychiatry & Neurology - Neurology (* (Not Available))Secondary
261QM1300XClinic/center - Multi-specialty (* (Not Available))Primary
261QM2500XClinic/center - Medical Specialty 41238 (Arizona)Secondary
363LP2300XNurse Practitioner - Primary Care (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:
Provider NameKeiko S Fakhraie
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1891991642
PECOS PAC ID: 9537212410
Enrollment ID: I20090727000196
Provider NameMary L Beck
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1629327010
PECOS PAC ID: 3375789704
Enrollment ID: I20150304001788
Provider NameAnita Marie Gilbert
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1124321088
PECOS PAC ID: 2163659301
Enrollment ID: I20151027002864
Provider NameTess Barnes
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1457705154
PECOS PAC ID: 3577824184
Enrollment ID: I20180222001235
Provider NameSteven Glenn Clemenson
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1174541874
PECOS PAC ID: 2860301249
Enrollment ID: I20201223002637
Provider NameRachel Margaret Greatwood
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1912431800
PECOS PAC ID: 9739512534
Enrollment ID: I20210713000462
Provider NameKenna Jan Stephenson
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1962697755
PECOS PAC ID: 2860570033
Enrollment ID: I20211013001513
Provider NameBrittany A Trevino-gombar
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1558670117
PECOS PAC ID: 2466844568
Enrollment ID: I20220124000762
Provider NameEric Clayton Christensen
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1134577810
PECOS PAC ID: 6800228396
Enrollment ID: I20220201000749
Provider NameJulie D Waite
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1245268788
PECOS PAC ID: 5395899769
Enrollment ID: I20230620002172
Provider NameJoseph A Cook
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1760639892
PECOS PAC ID: 8921167289
Enrollment ID: I20231009003161
Provider NameCaralee Skaggs
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1770082034
PECOS PAC ID: 4688936453
Enrollment ID: I20240104004669
Provider NameKathy Karen Kladar
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1497197594
PECOS PAC ID: 3173749181
Enrollment ID: I20240112000695

Reviews and Comments


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Phone: 623-889-7199    Fax: 623-889-7198
Nha T Lien Md Pc
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Phone: 909-239-4700    
Carefirst Wellness Associates Of Az Llc
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Medicare: Not Enrolled in Medicare
Practice Location: 12361 W Bola Dr Ste 109, Surprise, AZ 85378
Phone: 623-227-1000    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.