| Bluesky Family Medicine | |
|
2401 W Glendale Ave Ste 203 Phoenix AZ 85021-7677 | |
| (602) 772-5770 | |
| (602) 772-5771 |
| Full Name | Bluesky Family Medicine |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2401 W Glendale Ave Ste 203, Phoenix, Arizona |
| Authorized Official Name and Position | Sumaira Doorani (MANAGER) |
| Authorized Official Contact | 6027725770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bluesky Family Medicine 2401 W Glendale Ave Ste 203 Phoenix AZ 85021-7677 Ph: (602) 772-5770 | Bluesky Family Medicine 2401 W Glendale Ave Ste 203 Phoenix AZ 85021-7677 Ph: (602) 772-5770 |
| NPI Number | 1104122621 |
|---|---|
| Provider Enumeration Date | 01/31/2011 |
| Last Update Date | 04/23/2019 |
| Medicare PECOS PAC ID | 9436330701 |
|---|---|
| Medicare Enrollment ID | O20110218000603 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104122621 | NPI | - | NPPES |
| Z143146 | Other | AZ | PTAN |
| 8293938 | Medicaid | WA |
| Provider Name | Tariq Doorani |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1740240027 PECOS PAC ID: 8527118538 Enrollment ID: I20090615000042 |
| Provider Name | Patrick Michael Donnelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083786040 PECOS PAC ID: 6800042235 Enrollment ID: I20181008001574 |
| Provider Name | Kerstin Mcelvain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508320706 PECOS PAC ID: 1355504663 Enrollment ID: I20190306000921 |
| Provider Name | Kerstin Mcelvain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508320706 PECOS PAC ID: 1355504663 Enrollment ID: I20190827002858 |
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