NPIMap

Organization Active NPI

Paseo Medical Specialists LLC

  • Pulmonary Disease Physician
  • Glendale, AZ
National Provider Identifier
1235160995
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
21668 Issued in AZ
Legal business name
PASEO MEDICAL SPECIALISTS LLC
Practice address
13606 N 59TH Ave
# 1
Glendale, AZ 85304-1271
Phone
(602) 978-6100
Fax
(602) 978-2446
NPI assigned
Jul 5, 2006
Last updated
Sep 26, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Authorized official

Name
Manjit Bhamrah, M.D.NPI 1699706341
Title
President
Phone
(602) 978-6100

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 23394 AZ
Pulmonary Disease Physician 207RP1001X 21668 AZ Primary
Pulmonary Disease Physician 207RP1001X 28048 AZ

Addresses

Primary practice location

13606 N 59TH Ave
# 1
Glendale, AZ 85304-1271

Mailing address

13606 N 59TH Ave
# 1
Glendale, AZ 85304-1271
Phone (602) 978-6100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040719001419 AZ Part B Supplier - Clinic/Group Practice 7618956970 Receives reassigned benefits from 6 practitioners
Practice locations: Glendale, AZ

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D0902750Paseo Medical Specialists13606 N 59TH Ave Ste 1, Glendale, AZ 85304AccreditationFeb 12, 2027

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

13606 N 59th Ave
Ste 1
Glendale, AZ 85304
Phone (602) 978-6100

Practitioners & affiliated clinicians

Practitioners 9

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": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695686400000",
    "number": "1235160995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13606 N 59TH AVE",
            "address_2": "# 1",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853041271",
            "telephone_number": "602-978-6100",
            "fax_number": "602-978-2446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13606 N 59TH AVE",
            "address_2": "# 1",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853041271",
            "telephone_number": "602-978-6100",
            "fax_number": "602-978-2446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASEO MEDICAL SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2023-09-26",
        "certification_date": "2023-08-07",
        "status": "A",
        "authorized_official_last_name": "BHAMRAH",
        "authorized_official_first_name": "MANJIT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "602-978-6100",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "23394",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AZ",
            "license": "21668",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AZ",
            "license": "28048",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.