Elderhealth PLLC

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

Legal business name

ELDERHEALTH PLLC

Practice address

1846 E Innovation Park Dr
Oro Valley, AZ 85755-1963

Phone

(520) 329-2699

NPI assigned

Oct 8, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Corinne Self, MDNPI 1255629762

Title

Founder

Phone

(520) 829-9987

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 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

Practitioners 5

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

• Corinne M Self, M.D.

  • Internal Medicine Physician
  • Oro Valley, AZ
  • NPI 1255629762
  Medicare reassignment Care Compare group NPD Authorized official
• Erika Gundrey, FNP-C

  • Family Nurse Practitioner
  • Tucson, AZ
  • NPI 1578337523
  Medicare reassignment Care Compare group NPD
• Laura A Aylmer, MSS, LCSW

  • Clinical Social Worker
  • Tucson, AZ
  • NPI 1740356047
  Medicare reassignment NPD
• Melissa G Koon, ANP

  • Nurse Practitioner
  • Tucson, AZ
  • NPI 1952555120
  Medicare reassignment NPD
• Peggy M Schmidt, ARNP

  • Adult Health Nurse Practitioner
  • Tucson, AZ
  • NPI 1457347197
  Medicare reassignment NPD

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630540800000",
    "number": "1336746692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1846 E INNOVATION PARK DR",
            "city": "ORO VALLEY",
            "state": "AZ",
            "postal_code": "857551963",
            "telephone_number": "520-829-9987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1846 E INNOVATION PARK DR",
            "city": "ORO VALLEY",
            "state": "AZ",
            "postal_code": "857551963",
            "telephone_number": "520-329-2699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELDERHEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-08",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A",
        "authorized_official_last_name": "SELF",
        "authorized_official_first_name": "CORINNE",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "520-829-9987",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Ehizele Ediale, PT, DPT
• Christopher Edkins, PT, DPT
• Erica Lynne Eggman, FNP-C
• Stephanie Eijsink-Roehr, M.D.
• Mai El Gasim, MD
• Misty Elsby, CCC-SLP
• Enlightened Way Health LLC
• Sophia Deborah Erez, MS, LMFT, LPC
• Scott Esbit, HIS
• Lucia Monica Esparza, FNP-BC

• Geriatric Medicine (Internal Medicine) Physician in Oro Valley, AZ
• Providers in Oro Valley, AZ by specialty
• Geriatric Medicine (Internal Medicine) Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; 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.