Desert Ridge Medical Group - Medicare in Phoenix, AZ

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Desert Ridge Medical Group is a medicare enrolled "General Practice" provider in Phoenix, Arizona. Their current practice location is 21001 N Tatum Blvd Ste 78-1640, Phoenix, Arizona. You can reach out to their office (for appointments etc.) via phone at (480) 926-7800.

Desert Ridge Medical Group is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Desert Ridge Medical Group 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 1386133080.

Contact Information

Desert Ridge Medical Group
21001 N Tatum Blvd Ste 78-1640,
Phoenix, AZ 85050-5244
(480) 926-7800
(480) 926-2260

Map and Direction




Healthcare Provider's Profile

Full NameDesert Ridge Medical Group
TypeFacility
SpecialityGeneral Practice
Location21001 N Tatum Blvd Ste 78-1640, Phoenix, Arizona
Accepts Medicare AssignmentsMedicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1386133080
  • Provider Enumeration Date: 05/08/2018
  • Last Update Date: 10/13/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 5991056350
  • Enrollment ID: O20180924002341

Medical Identifiers

Medical identifiers for Desert Ridge Medical Group such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1386133080NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
111N00000XChiropractor (* (Not Available))Secondary
208100000XPhysical Medicine & Rehabilitation (* (Not Available))Secondary
208D00000XGeneral Practice (* (Not Available))Primary
225100000XPhysical Therapist (* (Not Available))Secondary
363A00000XPhysician 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. Desert Ridge Medical Group acts as a billing entity for following providers:
Provider NameSteven M Gabaldon
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1386692572
PECOS PAC ID: 7719927664
Enrollment ID: I20050510000606
Provider NameJacob D Hanson
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1477687432
PECOS PAC ID: 4981774502
Enrollment ID: I20080609000110
Provider NameSonja Gerard
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1366719965
PECOS PAC ID: 0941460018
Enrollment ID: I20120327000757
Provider NameAndre N Khoury
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1972803336
PECOS PAC ID: 7719160373
Enrollment ID: I20130419000387
Provider NameWalter Damper
Provider TypePractitioner - Physical Medicine And Rehabilitation
Provider IdentifiersNPI Number: 1639309180
PECOS PAC ID: 5496995854
Enrollment ID: I20130708000309
Provider NamePhoebe L Sampayo
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1710283247
PECOS PAC ID: 1557631181
Enrollment ID: I20170714000519
Provider NameZachary Bryen Goodman
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1568973428
PECOS PAC ID: 1254698137
Enrollment ID: I20171130002887
Provider NameYan Y Suleymanov
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1992282651
PECOS PAC ID: 5991055345
Enrollment ID: I20180905001376
Provider NameNicole Martin
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1114540564
PECOS PAC ID: 2163841206
Enrollment ID: I20200923001883
Provider NameJennifer A Davis
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1184355885
PECOS PAC ID: 0244614998
Enrollment ID: I20220830003551
Provider NameBrandon Livingood
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1639303993
PECOS PAC ID: 2365622982
Enrollment ID: I20250717002068
Provider NameBrandon Smith
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1720969660
PECOS PAC ID: 8325545494
Enrollment ID: I20251007001893
Provider NameMichael Bohrnsen
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1295020725
PECOS PAC ID: 8123336443
Enrollment ID: I20251104000923

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. Desert Ridge Medical Group 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 AddressPractice Location Address
Desert Ridge Medical Group
Po Box 6610,
Chandler, AZ 85246-6610

Ph: (480) 926-7800		Desert Ridge Medical Group
21001 N Tatum Blvd Ste 78-1640,
Phoenix, AZ 85050-5244

Ph: (480) 926-7800

Reviews and Comments



Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.