| Silver House Primary Care Pc | |
|
13507 N 145th Dr Surprise AZ 85379-6162 | |
| (202) 681-1274 | |
| Not Available |
| Full Name | Silver House Primary Care Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 13507 N 145th Dr, Surprise, Arizona |
| Authorized Official Name and Position | Aspen Decker (OWNER) |
| Authorized Official Contact | 2026811274 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Silver House Primary Care Pc 15411 W Waddell Rd Ste 102 Surprise AZ 85379-5170 Ph: (202) 681-1274 | Silver House Primary Care Pc 13507 N 145th Dr Surprise AZ 85379-6162 Ph: (202) 681-1274 |
| NPI Number | 1063287597 |
|---|---|
| Provider Enumeration Date | 11/15/2023 |
| Last Update Date | 03/21/2024 |
| Medicare PECOS PAC ID | 0749625838 |
|---|---|
| Medicare Enrollment ID | O20240228002882 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063287597 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Regina Jo Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275186413 PECOS PAC ID: 4183954936 Enrollment ID: I20190923000804 |
| Provider Name | Baldish K Khera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336777424 PECOS PAC ID: 9830508183 Enrollment ID: I20210517002516 |
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