| Ponderosa Family Care, Llc | |
|
806 S Ponderosa St Payson AZ 85541-5541 | |
| (928) 468-8603 | |
| Not Available |
| Full Name | Ponderosa Family Care, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 806 S Ponderosa St, Payson, Arizona |
| Authorized Official Name and Position | Alan P Michels (PHYSICIAN) |
| Authorized Official Contact | 9284688603 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ponderosa Family Care, Llc Po Box 2901 Payson AZ 85547-2901 Ph: (928) 468-9280 | Ponderosa Family Care, Llc 806 S Ponderosa St Payson AZ 85541-5541 Ph: (928) 468-8603 |
| NPI Number | 1144535626 |
|---|---|
| Provider Enumeration Date | 08/09/2010 |
| Last Update Date | 12/05/2014 |
| Medicare PECOS PAC ID | 1456548015 |
|---|---|
| Medicare Enrollment ID | O20101208000388 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144535626 | NPI | - | NPPES |
| 703422 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 29337 (Arizona) | Primary |
| 208000000X | Pediatrics | 29337 (Arizona) | Secondary |
| Provider Name | Darrell D Wadas |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1871565739 PECOS PAC ID: 4183654684 Enrollment ID: I20050815000709 |
| Provider Name | Judith A Hunt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023087459 PECOS PAC ID: 5294821997 Enrollment ID: I20071010000771 |
| Provider Name | Alan P Michels |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376512129 PECOS PAC ID: 0547328544 Enrollment ID: I20081020000593 |
| Provider Name | Lynne A Vigil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912967704 PECOS PAC ID: 2163607953 Enrollment ID: I20110420000494 |
| Provider Name | Kimberly B Alten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326175704 PECOS PAC ID: 4284787060 Enrollment ID: I20140916002828 |
| Provider Name | Alicia A Sexton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932627395 PECOS PAC ID: 6608140074 Enrollment ID: I20170922003372 |
| Provider Name | Emily Kathryne Blau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023662020 PECOS PAC ID: 4789915455 Enrollment ID: I20191010000804 |
| Provider Name | Donna Laluya |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134260144 PECOS PAC ID: 6800951567 Enrollment ID: I20210715004018 |
| Provider Name | Eric Joseph Vohs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366101024 PECOS PAC ID: 0840679320 Enrollment ID: I20220614002807 |
| Provider Name | Judith Lee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114085529 PECOS PAC ID: 9436217668 Enrollment ID: I20230214001652 |
| Provider Name | Sharon Caravetta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619693223 PECOS PAC ID: 6406211879 Enrollment ID: I20230509000065 |
| Provider Name | Lauren Washatka |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821651746 PECOS PAC ID: 7911233325 Enrollment ID: I20230926004428 |
Banner Payson Medical Center - Banner Health Clinic Payson Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 117 E Main St Ste A100, Payson, AZ 85541 Phone: 928-596-4500 Fax: 928-596-4545 | |
North Country Healthcare Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 126 E Main St Ste B, Payson, AZ 85541 Phone: 928-472-3700 Fax: 928-468-8605 | |
Payson Healthcare Management Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 126 E Main St Ste B, Payson, AZ 85541 Phone: 928-472-4675 Fax: 928-472-3427 | |
Banner Good Samaritan Liver Disease Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 117 E Main St, Suite A, Payson, AZ 85541 Phone: 602-839-4123 | |
Eagle Springs Family Medicine, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 903 E. Highway 260,, Suite 4, Payson, AZ 85541 Phone: 928-468-7700 Fax: 928-468-7703 | |
New Bridges Community Services Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 616 S Beeline Hwy Ste 101, Payson, AZ 85541 Phone: 623-281-9797 |