| Senior Doc Arizona Pc | |
|
14631 N Cave Creek Rd Ste 104 Phoenix AZ 85022-4100 | |
| (855) 434-7763 | |
| (949) 281-5550 |
| Full Name | Senior Doc Arizona Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 14631 N Cave Creek Rd Ste 104, Phoenix, Arizona |
| Authorized Official Name and Position | Angelica Leyla Soto (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 8554347763 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Senior Doc Arizona Pc 5 Hutton Centre Dr Ste 950 Santa Ana CA 92707-8714 Ph: (855) 434-7763 | Senior Doc Arizona Pc 14631 N Cave Creek Rd Ste 104 Phoenix AZ 85022-4100 Ph: (855) 434-7763 |
| NPI Number | 1700477627 |
|---|---|
| Provider Enumeration Date | 02/02/2021 |
| Last Update Date | 03/27/2025 |
| Medicare PECOS PAC ID | 6103232111 |
|---|---|
| Medicare Enrollment ID | O20211104002828 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700477627 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Catherine Lacourt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942232988 PECOS PAC ID: 8123080637 Enrollment ID: I20050923000304 |
| Provider Name | Jeremy J Bramwell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003178666 PECOS PAC ID: 9739321506 Enrollment ID: I20151016000901 |
| Provider Name | Kirby R Farnsworth |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1124464839 PECOS PAC ID: 4385948355 Enrollment ID: I20160829000906 |
| Provider Name | Mandy M Lim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205241866 PECOS PAC ID: 0446556435 Enrollment ID: I20170929002907 |
| Provider Name | Myungran Kim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639687684 PECOS PAC ID: 8921358086 Enrollment ID: I20180911001913 |
| Provider Name | Nicole Marie Musabelliu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457772311 PECOS PAC ID: 8628297900 Enrollment ID: I20191025001818 |
| Provider Name | Eunmee Chung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255981593 PECOS PAC ID: 0749613065 Enrollment ID: I20191127000654 |
| Provider Name | Renee Lopez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952946071 PECOS PAC ID: 6002242351 Enrollment ID: I20200204002016 |
| Provider Name | Amber N Nassif |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518598671 PECOS PAC ID: 1759719925 Enrollment ID: I20200415000308 |
| Provider Name | Andrea Tuthill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144777434 PECOS PAC ID: 0547543126 Enrollment ID: I20200527002136 |
| Provider Name | Tarah E Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174097299 PECOS PAC ID: 2264771740 Enrollment ID: I20210507002027 |
| Provider Name | John Mark Geiss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053651497 PECOS PAC ID: 5890933071 Enrollment ID: I20211104002956 |
| Provider Name | Mikaela Ariel Deans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366109746 PECOS PAC ID: 1153715586 Enrollment ID: I20220301002589 |
| Provider Name | Katherine Priscilla Garfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922717255 PECOS PAC ID: 2567834005 Enrollment ID: I20230210000571 |
| Provider Name | Micah Ruben Ruybalid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619695277 PECOS PAC ID: 7911370127 Enrollment ID: I20230308001468 |
| Provider Name | Christina Wohlforth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770363533 PECOS PAC ID: 6103272711 Enrollment ID: I20231101003663 |
| Provider Name | Kari Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568159226 PECOS PAC ID: 0345697330 Enrollment ID: I20231113003350 |
| Provider Name | Jeffrey John Thomas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932337136 PECOS PAC ID: 7315101003 Enrollment ID: I20240416002272 |
| Provider Name | Teryn Lies |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558141796 PECOS PAC ID: 0446691067 Enrollment ID: I20240514003389 |
| Provider Name | Anthony Marcus Yniguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871185686 PECOS PAC ID: 2769882331 Enrollment ID: I20240625003470 |
| Provider Name | Alexi Yarashevich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306340831 PECOS PAC ID: 6406119304 Enrollment ID: I20240626002795 |
Richard A. Snider, Md, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12010 S Warner Elliot Loop, Phoenix, AZ 85044 Phone: 480-893-2644 | |
Kelly H. Roy, Md, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1008 E Mcdowell Rd, Phoenix, AZ 85006 Phone: 602-358-8588 Fax: 602-688-6991 | |
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Deborah L Dykema Do Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 20045 N 19th Ave Bldg 9-151, Phoenix, AZ 85027 Phone: 602-978-1555 | |
Scottsdale Housecall Physicians, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11030 N Tatum Blvd Ste 101, Phoenix, AZ 85028 Phone: 602-687-8265 | |
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