Phoenix Geriatrics & Internal Medicine P L L C

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

15447 Issued in AZ

Legal business name

PHOENIX GERIATRICS & INTERNAL MEDICINE P L L C

Practice address

8300 E Dixileta Dr
#278
Scottsdale, AZ 85266-2273

Phone

(602) 770-2468

Fax

(480) 409-2512

NPI assigned

Oct 3, 2006

Organization subpart

No

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

Authorized official

Name

Luis L Gonzalez Jr., M.D.NPI 1639276520

Title

Physician

Phone

(602) 770-2468

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 4

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

• Luis L Gonzalez Jr., MD

  • Internal Medicine Physician
  • Scottsdale, AZ
  • NPI 1639276520

  Geriatric Medicine

  Medicare reassignment NPD Authorized official
• Jeanne Carver, MSN-FNP-C

  • Family Nurse Practitioner
  • Phoenix, AZ
  • NPI 1619395399
  Medicare reassignment NPD
• Patricia Sue Tillack, ANP

  • Adult Health Nurse Practitioner
  • Phoenix, AZ
  • NPI 1861459042
  NPD (past)
• Jerilyn Watson, M.D.

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1871589986
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733097600000",
    "number": "1346335676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28757",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852550162",
            "telephone_number": "602-770-2468",
            "fax_number": "480-409-2512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 E DIXILETA DR",
            "address_2": "#278",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852662273",
            "telephone_number": "602-770-2468",
            "fax_number": "480-409-2512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX GERIATRICS & INTERNAL MEDICINE P L L C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "602-770-2468",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "AZ",
            "license": "15447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phoenix Children'S Hospital, Inc.
• Phoenix Children'S Hospital, Inc.
• Phoenix Children'S Medical Group
• Phoenix Diagnostic Imaging Inc
• Phoenix Eye Group, LLC
• Phoenix Hospitalists PLC
• Phoenix Institute of Microvascular & Plastic Surgery PLLC
• Phoenix International Resources, LLC
• Phoenix Joint Center LLC
• Phoenix Lifeflight

• Geriatric Medicine (Internal Medicine) Physician in Scottsdale, AZ
• Providers in Scottsdale, 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 Dec 2, 2024; 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.