| Northwest Neuro Specialists, Pllc | |
|
5860 N. La Cholla Blvd Ste 100 Tucson AZ 85741 | |
| (520) 420-2045 | |
| (520) 420-2047 |
| Full Name | Northwest Neuro Specialists, Pllc |
|---|---|
| Speciality | Neurological Surgery |
| Location | 5860 N. La Cholla Blvd, Tucson, Arizona |
| Authorized Official Name and Position | Monica F Humphrey (CEO) |
| Authorized Official Contact | 5204202045 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Neuro Specialists, Pllc 5860 N. La Cholla Blvd Ste 100 Tucson AZ 85741 Ph: (520) 420-2045 | Northwest Neuro Specialists, Pllc 5860 N. La Cholla Blvd Ste 100 Tucson AZ 85741 Ph: (520) 420-2045 |
| NPI Number | 1619930336 |
|---|---|
| Provider Enumeration Date | 04/11/2006 |
| Last Update Date | 09/21/2023 |
| Certification Date | 09/21/2023 |
| Medicare PECOS PAC ID | 9335124684 |
|---|---|
| Medicare Enrollment ID | O20040621001397 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619930336 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Secondary |
| 207T00000X | Neurological Surgery | (* (Not Available)) | Primary |
| Provider Name | Richard V Chua |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1356334528 PECOS PAC ID: 6507812146 Enrollment ID: I20050427001143 |
| Provider Name | Sarah E Sullivan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1205039468 PECOS PAC ID: 8123111739 Enrollment ID: I20070912000228 |
| Provider Name | Thomas B Scully |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1659366300 PECOS PAC ID: 4981680535 Enrollment ID: I20100810001034 |
| Provider Name | Timothy K Putty |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1679568869 PECOS PAC ID: 1052507852 Enrollment ID: I20101118001129 |
| Provider Name | William E Holder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205178738 PECOS PAC ID: 9133341910 Enrollment ID: I20141111001315 |
| Provider Name | Kasey D Cross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356734800 PECOS PAC ID: 6002124799 Enrollment ID: I20150929003024 |
| Provider Name | Jennifer Ann Banek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255785481 PECOS PAC ID: 2163721713 Enrollment ID: I20160503000769 |
| Provider Name | Anna M Aparicio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437501749 PECOS PAC ID: 5496040388 Enrollment ID: I20160816002433 |
| Provider Name | Alicia Jarrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639634884 PECOS PAC ID: 3476894742 Enrollment ID: I20190415001416 |
| Provider Name | Matthew Putty |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1720460025 PECOS PAC ID: 8921302753 Enrollment ID: I20220722000736 |
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