| Prestige Virtual Care LLC | |
|
10830 N 71st Pl Ste 105 Scottsdale AZ 85254-6105 | |
| (480) 206-5619 | |
| Not Available |
| Full Name | Prestige Virtual Care LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 10830 N 71st Pl Ste 105, Scottsdale, Arizona |
| Authorized Official Name and Position | Bryan Eugene Hooppaw (CEO) |
| Authorized Official Contact | 4802065619 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prestige Virtual Care LLC 10830 N 71st Pl Ste 105 Scottsdale AZ 85254-6105 | Prestige Virtual Care LLC 10830 N 71st Pl Ste 105 Scottsdale AZ 85254-6105 Ph: (480) 206-5619 |
| NPI Number | 1548994072 |
|---|---|
| Provider Enumeration Date | 07/11/2022 |
| Last Update Date | 05/01/2023 |
| Certification Date | 05/01/2023 |
| Medicare PECOS PAC ID | 0042683963 |
|---|---|
| Medicare Enrollment ID | O20230223002425 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548994072 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Primary |
| 207R00000X | Internal Medicine | (NU) | Secondary |
| Provider Name | Susan Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205239324 PECOS PAC ID: 3678877875 Enrollment ID: I20160215002654 |
| Provider Name | Richard V Romero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679032577 PECOS PAC ID: 4486983582 Enrollment ID: I20190916002451 |
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