Ray Road Medical Group Llc is a medicare enrolled "General Practice" provider in Chandler, Arizona. Their current practice location is
1949 W Ray Rd Ste 23, Chandler, Arizona. You can reach out to their office (for appointments etc.) via phone at
(480) 917-1720.
Ray Road Medical Group Llc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Ray Road 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 1912498239.
Healthcare Provider's Profile
| Full Name | Ray Road Medical Group Llc |
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| Type | Facility |
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| Speciality | General Practice |
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| Location | 1949 W Ray Rd Ste 23, 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: 1912498239
- Provider Enumeration Date: 05/22/2018
- Last Update Date: 10/06/2025
Medicare PECOS Information:
- PECOS PAC ID: 5890045975
- Enrollment ID: O20180911002899
Medical Identifiers
Medical identifiers for Ray Road Medical Group Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1912498239 | 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.
Ray Road Medical Group Llc acts as a billing entity for following providers:
| Provider Name | Justin W Gomez |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1689839672
PECOS PAC ID: 3678626884
Enrollment ID: I20090806000056 |
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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 | Walter Damper |
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| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
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| Provider Identifiers | NPI Number: 1639309180
PECOS PAC ID: 5496995854
Enrollment ID: I20130708000309 |
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| Provider Name | Josefina Danielle Smith |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1336897164
PECOS PAC ID: 0244626752
Enrollment ID: I20220411000745 |
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| Provider Name | Jennifer A Davis |
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| Provider Type | Practitioner - Physician Assistant |
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| Provider Identifiers | NPI Number: 1184355885
PECOS PAC ID: 0244614998
Enrollment ID: I20220830003551 |
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| Provider Name | Kymberli Angelina Tiller |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1932734746
PECOS PAC ID: 6608260161
Enrollment ID: I20240729001176 |
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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. Ray Road 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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Ray Road Medical Group Llc
Po Box 6610,
Chandler, AZ 85246-6610
Ph: (480) 926-7800 | Ray Road Medical Group Llc
1949 W Ray Rd Ste 23,
Chandler, AZ 85224-4008
Ph: (480) 917-1720 |
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