| Peter Niemczyk, MD | |
|
5171 Cub Lake Rd, Bldg C Ste 340, Show Low, AZ 85901-7888 | |
| (928) 537-0111 | |
| (623) 582-9666 |
| Full Name | Peter Niemczyk |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 39 Years |
| Location | 5171 Cub Lake Rd, Show Low, Arizona |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518953041 | NPI | - | NPPES |
| 2Z2716 | Other | AZ | HEALTHNET |
| 477100 | Medicaid | AZ | |
| 5135633 | Other | AETNA | |
| 674661 | Other | CIGNA | |
| P00378324 | Other | RAILROAD MEDICARE | |
| AZ0156450 | Other | AZ | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 34718 (Arizona) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Canyon Vista Medical Center | Sierra vista, AZ | Hospital |
| Copper Queen Community Hospital | Bisbee, AZ | Hospital |
| Benson Hospital | Benson, AZ | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Sierra Vista Regional Health Center Medical Group Llc | 3779732854 | 47 |
| Entity Name | Sierra Vista Regional Health Center Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043575483 PECOS PAC ID: 3779732854 Enrollment ID: O20121004000679 |
| Mailing Address | Practice Location Address |
|---|---|
| Peter Niemczyk, MD 20325 N 51st Ave, #102, Glendale, AZ 85308-5674 Ph: (623) 780-2300 | Peter Niemczyk, MD 5171 Cub Lake Rd, Bldg C Ste 340, Show Low, AZ 85901-7888 Ph: (928) 537-0111 |
John Thomas Mansfield, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 4951 S White Mountain Rd Bldg A, Show Low, AZ 85901 Phone: 360-425-3720 Fax: 360-425-0090 |