Mr Miguel Fonseca-moreno, is a medicare enrolled "Physician Assistant" physician in Anthem, Arizona. He graduated from medical school in 2024 and has 1 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Ternion Physician Group, Pllc and his current practice location is
42104 N Venture Dr Ste D118, Anthem, Arizona. You can reach out to his office (for appointments etc.) via phone at
(623) 505-9880.
Mr Miguel Fonseca-moreno is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1417724402.
Physician's Profile
| Full Name | Mr Miguel Fonseca-moreno |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Experience | 1 Years |
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| Location | 42104 N Venture Dr Ste D118, Anthem, Arizona |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mr Miguel Fonseca-moreno graduated from medical school in 2024
NPI Data:
- NPI Number: 1417724402
- Provider Enumeration Date: 12/08/2023
- Last Update Date: 06/17/2025
Medicare PECOS Information:
- PECOS PAC ID: 9739611179
- Enrollment ID: I20241010001304
Medical Identifiers
Medical identifiers for Mr Miguel Fonseca-moreno such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1417724402 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207R00000X | Internal Medicine | 10680 (Arizona) | Secondary |
| 363A00000X | Physician Assistant | (* (Not Available)) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Ternion Physician Group, Pllc | 6709157589 | 6 |
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. Mr Miguel Fonseca-moreno 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 |
|---|
Mr Miguel Fonseca-moreno,
80 W Maryland Ave Apt 207,
Phoenix, AZ 85013-1266
Ph: (480) 686-3301 | Mr Miguel Fonseca-moreno,
42104 N Venture Dr Ste D118,
Anthem, AZ 85086-3837
Ph: (623) 505-9880 |
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