Pediatras Arizona

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PEDIATRAS ARIZONA

Practice address

1641 E Osborn Rd
Suite 3
Phoenix, AZ 85016-7146

Phone

(602) 218-6397

Fax

(602) 281-6391

NPI assigned

Sep 12, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Juan C Llusco, M.D.NPI 1669464210

Title

Owner/President

Phone

(602) 218-6397

Specialties & licenses 1

Addresses

Other identifiers 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

Locations

Practitioners 1

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

• Juan Llusco, MD

  • Pediatrics Physician
  • Phoenix, AZ
  • NPI 1669464210
  NPD (past) Authorized official

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480377600000",
    "number": "1427152164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 71608",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850501011",
            "telephone_number": "602-218-6397",
            "fax_number": "602-281-6391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1641 E OSBORN RD",
            "address_2": "SUITE 3",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167146",
            "telephone_number": "602-218-6397",
            "fax_number": "602-281-6391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRAS ARIZONA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2016-11-29",
        "status": "A",
        "authorized_official_last_name": "LLUSCO",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "602-218-6397",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "805872",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexis Dianne Pedersen, PA C
• Jennifer Pedersen, CRNA
• Michelle Rose Pedersen, ACNP
• Ali Pederson, PHARM.D.
• Mackenzie Tailleur Pederson
• Pediatria
• Pediatric Associates PC
• Pediatric Critical Care of Arizona LTD
• Pediatric Group Specialists, LTD.
• Pediatric Hematology Oncology Associates, P.C.

• Pediatrics Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; 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.