Cigna Health Care of Arizona Inc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

OSC 0012 Issued in AZ

Legal business name

CIGNA HEALTH CARE OF ARIZONA INC

Practice address

3003 N 3Rd St
Phoenix, AZ 85012-3031

Phone

(602) 282-9800

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Kevin Ellis, D.O.

Title

Chief Medial Director

Phone

(623) 277-2246

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• EVERNORTH Care Outpatient Surgery Doing business as

Listed as

Cigna Outpatient Surgery CenterCCN 03C0001223

Medicare certification status

Terminated Voluntary: merger or closure, Jul 2, 2024From the Provider of Services file

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686873600000",
    "number": "1265544191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8888 E RAINTREE DR FL 3",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603951",
            "telephone_number": "602-328-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 N 3RD ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850123031",
            "telephone_number": "602-282-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CIGNA HEALTH CARE OF ARIZONA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CHIEF MEDIAL DIRECTOR",
        "authorized_official_telephone_number": "623-277-2246",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AZ",
            "license": "OSC 0012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "631730",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EVERNORTH Care Outpatient Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sandra Cichon
• Matthew Frank Cichowski, DDS
• Valeria Ciciliano, DO
• Nicole Cieslak, FNTP, CPT
• Cigna Health and Life Insurance Company
• Cigna Health Care of Arizona Inc
• Cigna Health Care of Arizona Inc
• Cigna Health Care of Arizona Inc.
• Cigna Health Care of Arizona Inc.
• Cigna Health Care of Arizona Inc.

• Ambulatory Surgical Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Ambulatory Surgical Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2023; 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.