| Banner Concierge Services Arcadia LLC | |
|
4200 E Camelback Rd Ste 102 Phoenix AZ 85018-2718 | |
| (602) 229-2128 | |
| (602) 744-6348 |
| Full Name | Banner Concierge Services Arcadia LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 4200 E Camelback Rd Ste 102, Phoenix, Arizona |
| Authorized Official Name and Position | Todd Werner (PRESIDENT, CARE DELIVERY) |
| Authorized Official Contact | 6027474000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Banner Concierge Services Arcadia LLC 2901 N Central Ave Ste 160 Phoenix AZ 85012-2702 Ph: (602) 747-4000 | Banner Concierge Services Arcadia LLC 4200 E Camelback Rd Ste 102 Phoenix AZ 85018-2718 Ph: (602) 229-2128 |
| NPI Number | 1164110201 |
|---|---|
| Provider Enumeration Date | 04/26/2023 |
| Last Update Date | 03/06/2025 |
| Certification Date | 03/06/2025 |
| Medicare PECOS PAC ID | 3274988258 |
|---|---|
| Medicare Enrollment ID | O20231011001299 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164110201 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Secondary |
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Loren S Lasater |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023098662 PECOS PAC ID: 2860463965 Enrollment ID: I20040803000789 |
| Provider Name | Jeffrey M Curtis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144318700 PECOS PAC ID: 2466587043 Enrollment ID: I20140103001502 |
| Provider Name | Rishi Basnyat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609158799 PECOS PAC ID: 2567770159 Enrollment ID: I20150930003462 |
| Provider Name | Janna Assar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518221589 PECOS PAC ID: 0143528687 Enrollment ID: I20160921002311 |
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