Anasazi Medical Clinic PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

22725 Issued in AZ

Legal business name

ANASAZI MEDICAL CLINIC PC

Practice address

6641 East Baywood Ave
Suite #A2
Mesa, AZ 85206

Phone

(480) 396-2022

Fax

(480) 396-2035

NPI assigned

May 25, 2006

Last updated

Mar 28, 2008By 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

Dr. Tariq Khalil, MDNPI 1750337457

Title

Owner

Phone

(480) 398-2022

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 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, and the practitioner matching its NPPES authorized official.

• Tariq Khalil, MD

  • Internal Medicine Physician
  • Mesa, AZ
  • NPI 1750337457
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206662400000",
    "number": "1669428363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6641 EAST BAYWOOD AVE",
            "address_2": "SUITE #A2",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85206",
            "telephone_number": "480-396-2022",
            "fax_number": "480-396-2035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6641 EAST BAYWOOD AVE",
            "address_2": "SUITE #A2",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85206",
            "telephone_number": "480-396-2022",
            "fax_number": "480-396-2035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANASAZI MEDICAL CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2008-03-28",
        "status": "A",
        "authorized_official_last_name": "KHALIL",
        "authorized_official_first_name": "TARIQ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-398-2022",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "22725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• An Oasis of Healing, PLC
• Amy T An, CNM, ARNP
• Anasazi Foundation
• Anasazi Foundation
• Anasazi Integrated Health and Wellness
• John Curtis Anaya, C.C.P
• Sara Elizabeth Ancello, D.O.
• Rebecca Ortega Anchondo, RN, MSN, ANP-BC
• Anchored Hearts
• Anchored Hearts

• Internal Medicine Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.