Camelback Pulmonary and Critical Care, PLLC

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

Legal business name

CAMELBACK PULMONARY AND CRITICAL CARE, PLLC

Practice address

1111 E McDowell Rd FL 11
Phoenix, AZ 85006-2612

Phone

(602) 999-6268

NPI assigned

Apr 24, 2024

Last updated

Apr 24, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Grigory Horonenko Jr., DONPI 1356394035

Title

MD/Owner

Phone

(602) 999-6268

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Practitioners 1

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.

• Grigory Horonenko Jr., DO

  • Pulmonary Disease Physician
  • Phoenix, AZ
  • NPI 1356394035

  Critical Care Medicine

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1713916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713916800000",
    "number": "1548016223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4641 N 39TH PL",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850183612",
            "telephone_number": "602-999-6268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 E MCDOWELL RD FL 11",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062612",
            "telephone_number": "602-999-6268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMELBACK PULMONARY AND CRITICAL CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-24",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A",
        "authorized_official_last_name": "HORONENKO",
        "authorized_official_first_name": "GRIGORY",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "602-999-6268",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pulmonary Disease Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Pulmonary Disease Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.