| Carefirst Wellness Associates of Arizona | |
|
12361 W Bola Dr Ste 109 Surprise AZ 85378-9021 | |
| (623) 227-1000 | |
| (623) 227-2000 |
| Full Name | Carefirst Wellness Associates of Arizona |
|---|---|
| Speciality | Clinic/Center |
| Location | 12361 W Bola Dr, Surprise, Arizona |
| Authorized Official Name and Position | Haresh Boghara (OWNER) |
| Authorized Official Contact | 2142502140 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carefirst Wellness Associates of Arizona 12361 W Bola Dr Ste 109 Surprise AZ 85378-9021 Ph: (623) 227-1000 | Carefirst Wellness Associates of Arizona 12361 W Bola Dr Ste 109 Surprise AZ 85378-9021 Ph: (623) 227-1000 |
| NPI Number | 1598125791 |
|---|---|
| Provider Enumeration Date | 03/01/2016 |
| Last Update Date | 07/01/2024 |
| Certification Date | 07/01/2024 |
| Medicare PECOS PAC ID | 2466709274 |
|---|---|
| Medicare Enrollment ID | O20180725002648 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598125791 | NPI | - | NPPES |
| Provider Name | Keiko S Fakhraie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891991642 PECOS PAC ID: 9537212410 Enrollment ID: I20090727000196 |
| Provider Name | Kurtis Manley |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1992792758 PECOS PAC ID: 3971671405 Enrollment ID: I20090807000076 |
| Provider Name | Aaron J Jensen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1306099155 PECOS PAC ID: 2769543057 Enrollment ID: I20130613000626 |
| Provider Name | Mary Lee Beck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629327010 PECOS PAC ID: 3375789704 Enrollment ID: I20150304001788 |
| Provider Name | Anita Marie Gilbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124321088 PECOS PAC ID: 2163659301 Enrollment ID: I20151027002864 |
| Provider Name | Tess Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457705154 PECOS PAC ID: 3577824184 Enrollment ID: I20180222001235 |
| Provider Name | Ann B Mccombs |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1407029903 PECOS PAC ID: 5193070423 Enrollment ID: I20180608002297 |
| Provider Name | Tammy Lynn Tunis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447809926 PECOS PAC ID: 3779919949 Enrollment ID: I20200206001358 |
| Provider Name | Christine Creen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790331361 PECOS PAC ID: 8921437682 Enrollment ID: I20200331002374 |
| Provider Name | Steven Glenn Clemenson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174541874 PECOS PAC ID: 2860301249 Enrollment ID: I20201223002637 |
| Provider Name | Rachel Margaret Greatwood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912431800 PECOS PAC ID: 9739512534 Enrollment ID: I20210713000462 |
| Provider Name | Kenna Jan Stephenson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962697755 PECOS PAC ID: 2860570033 Enrollment ID: I20211013001513 |
| Provider Name | Brittany Trevino-gombar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558670117 PECOS PAC ID: 2466844568 Enrollment ID: I20220124000762 |
| Provider Name | Eric Clayton Christensen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134577810 PECOS PAC ID: 6800228396 Enrollment ID: I20220201000749 |
| Provider Name | Julie D Waite |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245268788 PECOS PAC ID: 5395899769 Enrollment ID: I20230620002172 |
| Provider Name | Joseph a Cook |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760639892 PECOS PAC ID: 8921167289 Enrollment ID: I20231009003161 |
| Provider Name | Caralee Skaggs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770082034 PECOS PAC ID: 4688936453 Enrollment ID: I20240104004669 |
| Provider Name | Donald Vincent Wall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659191906 PECOS PAC ID: 2062945314 Enrollment ID: I20241025000834 |
| Provider Name | Anthony J Cecchini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174089718 PECOS PAC ID: 9638403835 Enrollment ID: I20250115001602 |
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