| Roadrunner Medical Operations Az LLC | |
|
16515 S 40th St Ste 135 Phoenix AZ 85048-0560 | |
| (908) 748-4472 | |
| Not Available |
| Full Name | Roadrunner Medical Operations Az LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 16515 S 40th St Ste 135, Phoenix, Arizona |
| Authorized Official Name and Position | Kamran Tasharofi (OWNER) |
| Authorized Official Contact | 9087484471 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Roadrunner Medical Operations Az LLC 3961 E Chandler Blvd Ste 111-244 Phoenix AZ 85048-0303 Ph: (908) 748-4471 | Roadrunner Medical Operations Az LLC 16515 S 40th St Ste 135 Phoenix AZ 85048-0560 Ph: (908) 748-4472 |
| NPI Number | 1477412419 |
|---|---|
| Provider Enumeration Date | 01/16/2026 |
| Last Update Date | 01/16/2026 |
| Certification Date | 01/16/2026 |
| Medicare PECOS PAC ID | 6901381185 |
|---|---|
| Medicare Enrollment ID | O20260326002025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477412419 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (NU) | Primary |
| Provider Name | Kamran Tasharofi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174595466 PECOS PAC ID: 4981692092 Enrollment ID: I20250624003921 |
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