| Premier Medical Group, Llc | |
|
5030 S Mill Ave Ste D12 Tempe AZ 85282-6849 | |
| (480) 894-2823 | |
| (480) 664-0828 |
| Full Name | Premier Medical Group, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 5030 S Mill Ave Ste D12, Tempe, Arizona |
| Authorized Official Name and Position | Stacia Mendez (OFFICE MANAGER) |
| Authorized Official Contact | 4808942823 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Medical Group, Llc 5005 S Ash Ave Ste A-2 Tempe AZ 85282-6837 Ph: (602) 833-6585 | Premier Medical Group, Llc 5030 S Mill Ave Ste D12 Tempe AZ 85282-6849 Ph: (480) 894-2823 |
| NPI Number | 1467534487 |
|---|---|
| Provider Enumeration Date | 10/19/2006 |
| Last Update Date | 06/23/2023 |
| Medicare PECOS PAC ID | 9335132604 |
|---|---|
| Medicare Enrollment ID | O20040405000649 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467534487 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 07538449R (Arizona) | Primary |
| Provider Name | Robert J Bloomberg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952375362 PECOS PAC ID: 4688650799 Enrollment ID: I20041119000777 |
| Provider Name | Steven C Burns |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437154549 PECOS PAC ID: 7315966561 Enrollment ID: I20051116000725 |
| Provider Name | Robert H Page |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851398069 PECOS PAC ID: 4688650112 Enrollment ID: I20060109000877 |
| Provider Name | Curtis P Page |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295730539 PECOS PAC ID: 3678596186 Enrollment ID: I20060111000350 |
| Provider Name | Tina L Baldwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932361060 PECOS PAC ID: 1557434230 Enrollment ID: I20080715000260 |
| Provider Name | Shu Ying W Hsieh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912149147 PECOS PAC ID: 4880742683 Enrollment ID: I20090505000526 |
| Provider Name | Jesmina Shrestha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760855670 PECOS PAC ID: 3779883277 Enrollment ID: I20151207001370 |
| Provider Name | Leanndra Beard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801349311 PECOS PAC ID: 3173801578 Enrollment ID: I20161104000592 |
| Provider Name | Kirsten Rivas-andrews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265933717 PECOS PAC ID: 3971852690 Enrollment ID: I20180814001074 |
| Provider Name | Sarah L Bruner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710104229 PECOS PAC ID: 2769735711 Enrollment ID: I20181022002334 |
| Provider Name | Rachel Marissa Friedman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962953703 PECOS PAC ID: 0547537854 Enrollment ID: I20190401002437 |
| Provider Name | Joshua Z Bloomberg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881966448 PECOS PAC ID: 1557688355 Enrollment ID: I20190617001681 |
| Provider Name | Samira Zamani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225300882 PECOS PAC ID: 3476863002 Enrollment ID: I20190624002687 |
| Provider Name | Kelly P Harte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437536158 PECOS PAC ID: 9436468980 Enrollment ID: I20201124002191 |
| Provider Name | Hillary B Derose-caldera |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972090777 PECOS PAC ID: 7517363518 Enrollment ID: I20210830003189 |
| Provider Name | Alexandra L Lyons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235889205 PECOS PAC ID: 1355727462 Enrollment ID: I20220927002290 |
| Provider Name | Bradley D Gonik |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952862765 PECOS PAC ID: 0648505438 Enrollment ID: I20221220001979 |
| Provider Name | Jessica E Symmes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467152918 PECOS PAC ID: 3274995899 Enrollment ID: I20230815000566 |
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