| Yuma Gastro Llc | |
|
1390 W 16th St Yuma AZ 85364-4430 | |
| (928) 344-4325 | |
| (928) 344-3084 |
| Full Name | Yuma Gastro Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1390 W 16th St, Yuma, Arizona |
| Authorized Official Name and Position | Divesh R. Anireddy (SECRETARY) |
| Authorized Official Contact | 9287265151 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Yuma Gastro Llc 1390 W 16th St Yuma AZ 85364-4430 Ph: (928) 344-4325 | Yuma Gastro Llc 1390 W 16th St Yuma AZ 85364-4430 Ph: (928) 344-4325 |
| NPI Number | 1497074173 |
|---|---|
| Provider Enumeration Date | 05/20/2010 |
| Last Update Date | 03/28/2017 |
| Medicare PECOS PAC ID | 4981896677 |
|---|---|
| Medicare Enrollment ID | O20101013000920 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497074173 | NPI | - | NPPES |
| 529143 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Joshua Zara |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1295767077 PECOS PAC ID: 4789633629 Enrollment ID: I20050510001199 |
| Provider Name | Divesh Anireddy |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1427094770 PECOS PAC ID: 4880586221 Enrollment ID: I20051201000620 |
| Provider Name | Alec H Esker |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1245276591 PECOS PAC ID: 9436041878 Enrollment ID: I20051201000855 |
| Provider Name | Stacey L Kirkland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942236054 PECOS PAC ID: 0143240382 Enrollment ID: I20051201000933 |
| Provider Name | Cristiana Bortuzzo |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1891739017 PECOS PAC ID: 1759344666 Enrollment ID: I20060920000512 |
| Provider Name | Seth Miller |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1891991717 PECOS PAC ID: 2668597667 Enrollment ID: I20100914001161 |
| Provider Name | Victor Manuel Alvarez |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1972594158 PECOS PAC ID: 6002848322 Enrollment ID: I20110215000385 |
| Provider Name | Mary K Rush |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477961811 PECOS PAC ID: 4688895774 Enrollment ID: I20141014000917 |
| Provider Name | Kristie A Van Dyn Hoven |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144638925 PECOS PAC ID: 2466673462 Enrollment ID: I20141015002569 |
| Provider Name | Arun Pillai |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1336107994 PECOS PAC ID: 9133172042 Enrollment ID: I20141118002698 |
| Provider Name | Adrian J Estrada |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720486418 PECOS PAC ID: 8921324674 Enrollment ID: I20150224001424 |
| Provider Name | Zarine Kamaluddin |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1629325840 PECOS PAC ID: 1355616327 Enrollment ID: I20181003000142 |
| Provider Name | Cyrus M Ombaire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609358290 PECOS PAC ID: 4587909957 Enrollment ID: I20181213001714 |
| Provider Name | Hannah Kasuli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205392651 PECOS PAC ID: 3173865086 Enrollment ID: I20190424003073 |
| Provider Name | Zedeeka A Duke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073625711 PECOS PAC ID: 5496006462 Enrollment ID: I20190822000182 |
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