| Pueblo Family Physicians Ltd | |
|
4350 N 19th Ave Suite 6 Phoenix AZ 85015-4602 | |
| (602) 264-9191 | |
| (602) 532-2973 |
| Full Name | Pueblo Family Physicians Ltd |
|---|---|
| Speciality | Family Medicine |
| Location | 4350 N 19th Ave, Phoenix, Arizona |
| Authorized Official Name and Position | Rick Johns (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 6028508913 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pueblo Family Physicians Ltd 4350 N 19th Ave Ste 6 Phoenix AZ 85015-4602 Ph: (602) 850-8913 | Pueblo Family Physicians Ltd 4350 N 19th Ave Suite 6 Phoenix AZ 85015-4602 Ph: (602) 264-9191 |
| NPI Number | 1790798072 |
|---|---|
| Provider Enumeration Date | 08/15/2006 |
| Last Update Date | 02/09/2024 |
| Medicare PECOS PAC ID | 2062497936 |
|---|---|
| Medicare Enrollment ID | O20040623001193 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790798072 | NPI | - | NPPES |
| 423779 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 2325 (Arizona) | Primary |
| Provider Name | Janine M Sutter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932106192 PECOS PAC ID: 3375585409 Enrollment ID: I20050527000678 |
| Provider Name | Donald G Cunningham |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1508855719 PECOS PAC ID: 0345296943 Enrollment ID: I20100308000790 |
| Provider Name | Douglas L Cunningham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104856475 PECOS PAC ID: 8123142072 Enrollment ID: I20100828000131 |
| Provider Name | John Michael Holder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245368794 PECOS PAC ID: 9739368457 Enrollment ID: I20110127000589 |
| Provider Name | Judith A Bergman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184617128 PECOS PAC ID: 3072798560 Enrollment ID: I20110427000288 |
| Provider Name | Michelle North |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114296159 PECOS PAC ID: 5890950398 Enrollment ID: I20120709000333 |
| Provider Name | Melissa Leigh Suchon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538573225 PECOS PAC ID: 7012138142 Enrollment ID: I20141014002351 |
| Provider Name | Christopher M Serrone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366830945 PECOS PAC ID: 5597077487 Enrollment ID: I20150707001243 |
| Provider Name | Scott Sabish |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497128680 PECOS PAC ID: 9638102882 Enrollment ID: I20151214002608 |
| Provider Name | Trey Powrzanas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821400755 PECOS PAC ID: 7517187339 Enrollment ID: I20160503000822 |
| Provider Name | Robert Hoadley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578007480 PECOS PAC ID: 5597037515 Enrollment ID: I20170824003364 |
| Provider Name | Micaela A Simon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235681370 PECOS PAC ID: 2769498443 Enrollment ID: I20170919004135 |
| Provider Name | Phillip Steven Prusinski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033661244 PECOS PAC ID: 3274807581 Enrollment ID: I20171017000739 |
| Provider Name | Tony R. Nazario |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730413063 PECOS PAC ID: 5890052971 Enrollment ID: I20171128000390 |
| Provider Name | Jean Marseille |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912417577 PECOS PAC ID: 7618236134 Enrollment ID: I20180109000440 |
| Provider Name | Daniela Haimov |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114523719 PECOS PAC ID: 3173938057 Enrollment ID: I20210301000221 |
| Provider Name | Kayla Pokrzywinski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063029700 PECOS PAC ID: 2466868013 Enrollment ID: I20210308000711 |
| Provider Name | Esther Shalamov |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366001257 PECOS PAC ID: 9739596636 Enrollment ID: I20210319001427 |
| Provider Name | Lea Nickolas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306471644 PECOS PAC ID: 8224435268 Enrollment ID: I20210917002349 |
| Provider Name | Patricia Li |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003579830 PECOS PAC ID: 5698165983 Enrollment ID: I20211130002597 |
| Provider Name | Nikita Garrett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336850387 PECOS PAC ID: 2860858743 Enrollment ID: I20230518002700 |
Richard A. Snider, Md, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12010 S Warner Elliot Loop, Phoenix, AZ 85044 Phone: 480-893-2644 | |
Kelly H. Roy, Md, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1008 E Mcdowell Rd, Phoenix, AZ 85006 Phone: 602-358-8588 Fax: 602-688-6991 | |
My Family Doctor In The Valley Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11030 N Tatum Blvd, Ste 101, Phoenix, AZ 85028 Phone: 602-687-8265 | |
Deborah L Dykema Do Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 20045 N 19th Ave Bldg 9-151, Phoenix, AZ 85027 Phone: 602-978-1555 | |
Scottsdale Housecall Physicians, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11030 N Tatum Blvd Ste 101, Phoenix, AZ 85028 Phone: 602-687-8265 | |
Wings Of Hope Medical Services, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11022 N 28th Dr Ste 205, Phoenix, AZ 85029 Phone: 602-971-0304 Fax: 602-971-0305 | |
Sheperd Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9150 W Indian School Rd Ste 111b, Phoenix, AZ 85037 Phone: 623-247-2300 Fax: 623-247-1939 |