Ocotillo Medical Group Llc is a medicare enrolled "General Practice" provider in Chandler, Arizona. Their current practice location is
2815 E. Ocotillo Rd, #4, Chandler, Arizona. You can reach out to their office (for appointments etc.) via phone at
(480) 926-7800.
Ocotillo Medical Group Llc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Ocotillo Medical Group Llc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1538692470.
Healthcare Provider's Profile
| Full Name | Ocotillo Medical Group Llc |
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| Type | Facility |
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| Speciality | General Practice |
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| Location | 2815 E. Ocotillo Rd, Chandler, Arizona |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1538692470
- Provider Enumeration Date: 04/07/2017
- Last Update Date: 10/11/2023
Medicare PECOS Information:
- PECOS PAC ID: 2567748056
- Enrollment ID: O20171004003783
Medical Identifiers
Medical identifiers for Ocotillo Medical Group Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1538692470 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 111N00000X | Chiropractor | (* (Not Available)) | Secondary |
| 208100000X | Physical Medicine & Rehabilitation | (* (Not Available)) | Secondary |
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
| 363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Ocotillo Medical Group Llc acts as a billing entity for following providers:
| Provider Name | John J Koc |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1659429215
PECOS PAC ID: 1951200609
Enrollment ID: I20040102000119 |
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| Provider Name | Mollie E Callanan |
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| Provider Type | Practitioner - Physical Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1255369849
PECOS PAC ID: 4880637313
Enrollment ID: I20050606001134 |
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| Provider Name | Troy C Ciavaglia |
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| Provider Type | Practitioner - Physical Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1740400258
PECOS PAC ID: 7113052267
Enrollment ID: I20100316000061 |
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| Provider Name | Nathan E Grinder |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1164726717
PECOS PAC ID: 5597949008
Enrollment ID: I20110407000495 |
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| Provider Name | Sonja Gerard |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1366719965
PECOS PAC ID: 0941460018
Enrollment ID: I20120327000757 |
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| Provider Name | Genesis Larkins |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1194426080
PECOS PAC ID: 3072988559
Enrollment ID: I20230414001567 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ocotillo Medical Group Llc is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Ocotillo Medical Group Llc
Po Box 6610,
Chandler, AZ 85246-6610
Ph: (480) 926-7800 | Ocotillo Medical Group Llc
2815 E. Ocotillo Rd, #4,
Chandler, AZ 85233
Ph: (480) 926-7800 |
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