| Ahwatukee Health Care, Llc | |
|
16515 S 40th St Ste 119 Phoenix AZ 85048-0559 | |
| (480) 272-8450 | |
| (480) 272-8307 |
| Full Name | Ahwatukee Health Care, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 16515 S 40th St Ste 119, Phoenix, Arizona |
| Authorized Official Name and Position | Mary Ann Holton (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 4802728450 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ahwatukee Health Care, Llc 16515 S 40th St Ste 119 Phoenix AZ 85048-0559 Ph: (480) 272-8450 | Ahwatukee Health Care, Llc 16515 S 40th St Ste 119 Phoenix AZ 85048-0559 Ph: (480) 272-8450 |
| NPI Number | 1053803676 |
|---|---|
| Provider Enumeration Date | 05/30/2018 |
| Last Update Date | 05/06/2025 |
| Medicare PECOS PAC ID | 8224383906 |
|---|---|
| Medicare Enrollment ID | O20180814001316 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053803676 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Natalie Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386005270 PECOS PAC ID: 5890083091 Enrollment ID: I20161004000164 |
| Provider Name | Elizabeth Bochtler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215114343 PECOS PAC ID: 1456509454 Enrollment ID: I20170608002124 |
| Provider Name | Daniel M Pacheco |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346401759 PECOS PAC ID: 9830367739 Enrollment ID: I20170906001382 |
| Provider Name | Dormico Latashia Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841892593 PECOS PAC ID: 3375954480 Enrollment ID: I20201120002265 |
| Provider Name | Lillian L Espinoza |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841643277 PECOS PAC ID: 2567856156 Enrollment ID: I20220422000540 |
| Provider Name | Angela Woodman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063176345 PECOS PAC ID: 7113303504 Enrollment ID: I20221010000297 |
| Provider Name | Lleva Frances Groves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295449627 PECOS PAC ID: 9931566122 Enrollment ID: I20230602001121 |
| Provider Name | Francis Reynold Serdenia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730871948 PECOS PAC ID: 9830543586 Enrollment ID: I20230928002059 |
| Provider Name | Donn R Yeager |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427414531 PECOS PAC ID: 4183074149 Enrollment ID: I20240103002080 |
| Provider Name | Edward Christian Camacho |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245085240 PECOS PAC ID: 2466990767 Enrollment ID: I20240819000613 |
| Provider Name | Eliza Sabo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174363238 PECOS PAC ID: 1355881285 Enrollment ID: I20240906001110 |
| Provider Name | Jared D Posey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093483711 PECOS PAC ID: 5890235048 Enrollment ID: I20240913002973 |
| Provider Name | Maria Francisca Davila |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184392854 PECOS PAC ID: 7618408915 Enrollment ID: I20240926003459 |
| Provider Name | Sarah Bortz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144062746 PECOS PAC ID: 1456884899 Enrollment ID: I20241024000516 |
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