| Kyle Jervis, PA-C | |
|
13677 W Mcdowell Rd # Az85395, Goodyear, AZ 85395-2635 | |
| (623) 882-1500 | |
| Not Available |
| Full Name | Kyle Jervis |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 13677 W Mcdowell Rd # Az85395, Goodyear, Arizona |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053846659 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 7195 (Arizona) | Primary |
| 363A00000X | Physician Assistant | C06468 (Maryland) | Secondary |
| Entity Name | Emergency Group of Arizona Professional Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215275433 PECOS PAC ID: 1355596644 Enrollment ID: O20130313000442 |
| Entity Name | Arizona Acute Medical Services 1 PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154860674 PECOS PAC ID: 6204113970 Enrollment ID: O20170505001284 |
| Entity Name | Tec Emergency Physicians of Arizona, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245772870 PECOS PAC ID: 6204256084 Enrollment ID: O20201016000157 |
| Mailing Address | Practice Location Address |
|---|---|
| Kyle Jervis, PA-C 19947 W Rancho Dr, Litchfield Park, AZ 85340-2667 Ph: (602) 740-0131 | Kyle Jervis, PA-C 13677 W Mcdowell Rd # Az85395, Goodyear, AZ 85395-2635 Ph: (623) 882-1500 |
Ebenezer Khuram Qureshi, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1507 N Litchfield Rd Ste 200, Goodyear, AZ 85395 Phone: 623-215-0040 Fax: 623-935-9602 |
Maci Noble, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 15400 W Roosevelt St Apt 3099, Goodyear, AZ 85338 Phone: 541-621-6964 |
Jenna L Graham, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 13555 W Mcdowell Rd, Goodyear, AZ 85395 Phone: 623-935-5522 Fax: 623-935-3220 |
Ms. Stacie Lyn Patterson, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 13677 W. Mc Dowell Road, 201, Goodyear, AZ 85395 Phone: 623-882-1926 Fax: 623-882-1709 |
Grace Mary Ruettinger, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 13471 W Cornerstone Blvd, Goodyear, AZ 85395 Phone: 480-964-2273 |
Katrina Carbonell Aquino, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 13677 W Mcdowell Rd, Goodyear, AZ 85395 Phone: 623-882-1500 |
Mr. Mitchell D Erickson, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 13677 W Mcdowell Rd, Goodyear, AZ 85395 Phone: 623-882-1500 |