| Prime Medical Group, Llc | |
|
652 E Warner Rd Ste 107 Gilbert AZ 85296-3073 | |
| (480) 539-8680 | |
| (480) 539-1763 |
| Full Name | Prime Medical Group, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 652 E Warner Rd Ste 107, Gilbert, Arizona |
| Authorized Official Name and Position | Andria M Keeble (OFFICE MANAGER) |
| Authorized Official Contact | 4805398680 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Medical Group, Llc 652 E Warner Rd Ste 107 Gilbert AZ 85296-3073 Ph: (480) 539-8680 | Prime Medical Group, Llc 652 E Warner Rd Ste 107 Gilbert AZ 85296-3073 Ph: (480) 539-8680 |
| NPI Number | 1336679414 |
|---|---|
| Provider Enumeration Date | 06/12/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 1153693379 |
|---|---|
| Medicare Enrollment ID | O20170823002880 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336679414 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Arizona) | Primary |
| Provider Name | Pearl Maurer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639167174 PECOS PAC ID: 0840211751 Enrollment ID: I20051207000606 |
| Provider Name | Mark Schlotterback |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861449944 PECOS PAC ID: 1658364922 Enrollment ID: I20100917001136 |
| Provider Name | Sunildat D Maheshwari |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417153164 PECOS PAC ID: 9537356563 Enrollment ID: I20101203000023 |
| Provider Name | Neerja K Sethi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649390709 PECOS PAC ID: 2769671890 Enrollment ID: I20110105000681 |
| Provider Name | Roxie L Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558359109 PECOS PAC ID: 2062446339 Enrollment ID: I20120831000700 |
| Provider Name | Jaclyn R Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396972444 PECOS PAC ID: 0648408682 Enrollment ID: I20140120000531 |
| Provider Name | Maria Kenneally |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205821493 PECOS PAC ID: 3971400763 Enrollment ID: I20160426001656 |
| Provider Name | Lydia Jacintha Barboza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689049629 PECOS PAC ID: 2668771908 Enrollment ID: I20161207001201 |
| Provider Name | Tyler John Gale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790279685 PECOS PAC ID: 1355695214 Enrollment ID: I20181112001293 |
| Provider Name | Kara Lindsay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730789876 PECOS PAC ID: 8729467113 Enrollment ID: I20220615000120 |
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