Arizona Family & Geriatric Medicine PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

ARIZONA FAMILY & GERIATRIC MEDICINE PLLC

Practice address

5602 E. Main St.
Mesa, AZ 85205

Phone

(480) 854-9004

Fax

(480) 832-1858

NPI assigned

Aug 27, 2010

Organization subpart

No

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

Authorized official

Name

Minh Luong, M.D.NPI 1083820781

Title

Physician, Co-Owner

Phone

(480) 854-9004

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 5

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

• Minh Tran Luong, MD

  • Family Medicine Physician
  • Mesa, AZ
  • NPI 1083820781
  Medicare reassignment NPD Authorized official
• Phuong Pham

  • Family Nurse Practitioner
  • Chandler, AZ
  • NPI 1760094098
  Medicare reassignment NPD
• Katrina E Bair, PA

  • Physician Assistant
  • Scottsdale, AZ
  • NPI 1629535828
  Medicare reassignment
• Sydney Jill Berger, PA-C

  • Physician Assistant
  • Mesa, AZ
  • NPI 1932660990
  Medicare reassignment
• Priscilla Marie Luong, NP

  • Primary Care Nurse Practitioner
  • Mesa, AZ
  • NPI 1770810715
  Medicare reassignment

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

{
    "created_epoch": "1282867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507766400000",
    "number": "1740596733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5602 E. MAIN ST.",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85205",
            "telephone_number": "480-854-9004",
            "fax_number": "480-832-1858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5602 E. MAIN ST.",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85205",
            "telephone_number": "480-854-9004",
            "fax_number": "480-832-1858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA FAMILY & GERIATRIC MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-27",
        "last_updated": "2017-10-12",
        "status": "A",
        "authorized_official_last_name": "LUONG",
        "authorized_official_first_name": "MINH",
        "authorized_official_title_or_position": "PHYSICIAN, CO-OWNER",
        "authorized_official_telephone_number": "480-854-9004",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AZ",
            "license": "41809",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Arizona Family Care Network Inc.
• Arizona Family Health & Rehab Center, P C.
• Arizona Family Institute
• Arizona Family Institute
• Arizona Foot and Ankle Medicine and Surgery, PLC

• Primary Care Clinic/Center in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Primary Care Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2017; 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.