Premiere Gi PLLC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

PREMIERE GI PLLC

Practice address

11505 Palmbrush TRL Ste 200
Lakewood Ranch, FL 34202-2904

Phone

(941) 334-9040

Fax

(941) 334-9030

NPI assigned

Jul 20, 2023

Organization subpart

No

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

Authorized official

Name

Arun Khazanchi, MDNPI 1003961236

Title

Member Owner

Phone

(941) 334-9040

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 5

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.

• Arun P Khazanchi, MD

  • Gastroenterology Physician
  • Lakewood Ranch, FL
  • NPI 1003961236
  Medicare reassignment Care Compare group NPD Authorized official
• Amanda Bryn Lee, ARNP

  • Family Nurse Practitioner
  • Parrish, FL
  • NPI 1376864264
  Medicare reassignment Care Compare group NPD
• Tracy Osborne, PA-C

  • Medical Physician Assistant
  • Lakewood Ranch, FL
  • NPI 1902268998
  Medicare reassignment Care Compare group
• Mark Andrew Kocab, MD

  • Gastroenterology Physician
  • Kalamazoo, MI
  • NPI 1942271606

  FL

  Medicare reassignment NPD
• Joshua B Tennenbaum, D.O.

  • Anatomic Pathology & Clinical Pathology Physician
  • Memphis, TN
  • NPI 1356543441

  FL

  Medicare reassignment NPD

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

{
    "created_epoch": "1689811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689811200000",
    "number": "1336829894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11505 PALMBRUSH TRL STE 200",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342022904",
            "telephone_number": "941-334-9040",
            "fax_number": "941-334-9030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11505 PALMBRUSH TRL STE 200",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342022904",
            "telephone_number": "941-334-9040",
            "fax_number": "941-334-9030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERE GI PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-20",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A",
        "authorized_official_last_name": "KHAZANCHI",
        "authorized_official_first_name": "ARUN",
        "authorized_official_title_or_position": "MEMBER OWNER",
        "authorized_official_telephone_number": "941-334-9040",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in Lakewood Ranch, FL
• Providers in Lakewood Ranch, FL by specialty
• Gastroenterology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; 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.