Specialty Pediatrics Medical Group PLLC

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

Legal business name

SPECIALTY PEDIATRICS MEDICAL GROUP PLLC

Practice address

8765 W Kelton LN Ste C102
Peoria, AZ 85382-5012

Phone

(480) 812-5040

NPI assigned

Apr 3, 2023

Organization subpart

No

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

Authorized official

Name

Pankaj Jain, MDNPI 1174941108

Title

President/Ceo

Phone

(480) 812-5040

Specialties & licenses 1

Addresses

Other names 1

• Specialty Pediatric Solutions Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 2

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

• Pankaj Jain, MD

  • Pediatric Cardiology Physician
  • Mesa, AZ
  • NPI 1174941108
  Medicare reassignment NPD Authorized official
• Priti Singh, MD

  • Internal Medicine Physician
  • Peoria, AZ
  • NPI 1316276462
  NPD (past)

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692144000000",
    "number": "1508561325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8765 W KELTON LN",
            "address_2": "BLDG C1, STE-102",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853825012",
            "telephone_number": "480-812-5040",
            "fax_number": "520-552-6487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8765 W KELTON LN STE C102",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853825012",
            "telephone_number": "480-812-5040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY PEDIATRICS MEDICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-03",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A",
        "authorized_official_last_name": "JAIN",
        "authorized_official_first_name": "PANKAJ",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "480-812-5040",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Specialty Pediatric Solutions",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Specialty Pediatric Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jenna L Sparks, LMT
• Tam Spat, ND
• Alyssa Breanne Spavor, RPH
• Myles Spearman, PT, DPT
• Kayla Michelle Spears, MS OTR/L
• Cherie Speight
• Sharon Spence, MA, L.P.C.
• Bradley Spencer
• Kathryn Spicer
• Spine Center of Arizona, PLLC

• Pediatric Cardiology Physician in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Pediatric Cardiology Physician in Arizona

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