Organization Active NPI

Synergy Clinical PLLC

  • Family Medicine Physician
  • Green Valley, AZ
National Provider Identifier
1083137038
Registry record updated Nov 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SYNERGY CLINICAL PLLC
Practice address
250 W Continental Rd Ste 500
Green Valley, AZ 85622-3592
Phone
(520) 427-6051
NPI assigned
Jul 21, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2017

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

Authorized official

Name
Ms. Katarzyna Wegner, NPNPI 1962801902
Title
Co-Owner
Phone
(520) 427-6051

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

250 W Continental Rd Ste 500
Green Valley, AZ 85622-3592

Mailing address

250 W Continental Rd Ste 500
Green Valley, AZ 85622-3592
Phone (520) 427-6051

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171122002771 AZ Part B Supplier - Clinic/Group Practice 5193082386 Receives reassigned benefits from 1 practitioner
Practice locations: Green Valley, AZ

National Provider Directory

National Provider Directory

Locations

175 S La Canada Dr
Ste 171
Green Valley, AZ 85614
Phone (520) 260-0670

250 W Continental Rd
Ste 500
Green Valley, AZ 85622
Phone (520) 260-0670

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1500595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511740800000",
    "number": "1083137038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 W CONTINENTAL RD STE 500",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856223592",
            "telephone_number": "520-427-6051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 W CONTINENTAL RD STE 500",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856223592",
            "telephone_number": "520-427-6051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY CLINICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-21",
        "last_updated": "2017-11-27",
        "status": "A",
        "authorized_official_last_name": "WEGNER",
        "authorized_official_first_name": "KATARZYNA",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "520-427-6051",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.