Desert Kids Pediatrics PLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

28558 Issued in AZ

Legal business name

DESERT KIDS PEDIATRICS PLC

Practice address

6707 N 19TH Ave
Ste 109
Phoenix, AZ 85015-1105

Phone

(602) 973-9234

Fax

(602) 973-9271

NPI assigned

Oct 7, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Graviola R. Brooks-Martinez, MDNPI 1548253719

Title

Owner/Physician

Phone

(602) 973-9234

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/7810/brand/1/csg/1/fhir/r4

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Graviola Ruth Brooks-Martinez, M.D.

  • Pediatrics Physician
  • Phoenix, AZ
  • NPI 1548253719
  NPD (past) Authorized official
• Long H.T. Le, M.D.

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1336451525
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375315200000",
    "number": "1043461171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6707 N 19TH AVE",
            "address_2": "STE 109",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850151105",
            "telephone_number": "602-973-9234",
            "fax_number": "602-973-9271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6707 N 19TH AVE",
            "address_2": "STE 109",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850151105",
            "telephone_number": "602-973-9234",
            "fax_number": "602-973-9271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT KIDS PEDIATRICS PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-07",
        "last_updated": "2013-08-01",
        "status": "A",
        "authorized_official_last_name": "BROOKS-MARTINEZ",
        "authorized_official_first_name": "GRAVIOLA",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "602-973-9234",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "28558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "375531",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Desert Hospitalists, PC
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• Desert Institute for Spine Care PC
• Desert Institute of Classical Homeopathy
• Desert IV Therapy PLLC
• Desert Lily Dental
• Desert Lily Healthcare, Inc.
• Desert Living Assisted Living LLC
• Desert Medical Billing and Consulting Services, Inc
• Desert Mercy Diabetes and Thyroid Center PLLC

• Pediatrics Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.