Active NPI
Alexandre Efimov, M.D.
- Family Medicine Physician
- Mesa, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 63514
- Practice address
- 1300 S Country Club Dr Ste 3
Mesa, AZ 85210-5162 - Phone
- (480) 827-5500
- NPI assigned
- Jun 15, 2016
- Last updated
- Oct 31, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | R-10584 | IA | |
| Family Medicine Physician | 207Q00000X | 63514 | AZ | Primary |
Addresses
Primary practice location
1300 S Country Club Dr Ste 3
Mesa, AZ 85210-5162
Mailing address
1300 S Country Club Dr Ste 3
Mesa, AZ 85210-5162
Phone (480) 827-5500
Other practice location 1
1201 3rd Ave SE
Cedar Rapids, IA 52403-4009
Phone (319) 730-7300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- BHSM Rehabilitation LLC
Practice addresses (Care Compare)
1300 S Country Club Dr
Suite 3
Mesa, AZ 85210-5162
Phone (480) 827-5500
2225 W Southern Ave
Mesa, AZ 85202-4716
Phone (623) 888-3502
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Banner Primary Care Physicians Arizona LLC | Current | Accepting new patients | |
| Banner Primary Care Physicians Arizona LLC | Current | Accepting new patients | |
| Banner Primary Care Physicians Arizona LLC | Current | Accepting new patients | |
| Banner Primary Care Physicians Arizona LLC | Past | Accepting new patients |
Locations
1300 S Country Club Dr
Ste 3
Mesa, AZ 85210
Phone (480) 827-5500
13640 N Plaza del Rio Blvd
Peoria, AZ 85381
Phone (623) 876-3800
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Primary Care Clinic/Center
- Phoenix, AZ
- NPI 1659640902
-
- Clinical Medical Laboratory
- Peoria, AZ
- NPI 1649544362
-
- Primary Care Clinic/Center
- Phoenix, AZ
- NPI 1790306066
-
- Primary Care Clinic/Center
- Phoenix, AZ
- NPI 1417238908
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Sun City, AZ
- NPI 1023051927
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698710400000",
"number": "1518317031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 S COUNTRY CLUB DR STE 3",
"city": "MESA",
"state": "AZ",
"postal_code": "852105162",
"telephone_number": "480-827-5500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 S COUNTRY CLUB DR STE 3",
"city": "MESA",
"state": "AZ",
"postal_code": "852105162",
"telephone_number": "480-827-5500"
}
],
"practiceLocations": [
{
"address_1": "1201 3rd Ave SE",
"address_purpose": "LOCATION",
"city": "Cedar Rapids",
"state": "IA",
"postal_code": "524034009",
"country_code": "US",
"telephone_number": "319-730-7300",
"fax_number": "319-730-7368",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EFIMOV",
"first_name": "ALEXANDRE",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-06-15",
"last_updated": "2023-10-31",
"certification_date": "2023-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "R-10584",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AZ",
"license": "63514",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.