Pueblo Family Physicians LTD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2325 Issued in AZ

Legal business name

PUEBLO FAMILY PHYSICIANS LTD

Practice address

4350 N 19TH Ave
Suite 6
Phoenix, AZ 85015-4602

Phone

(602) 264-9191

Fax

(602) 532-2973

NPI assigned

Aug 15, 2006

Organization subpart

Yes

Parent organization

PUEBLO FAMILY PHYSICIANS LTDAs reported in NPPES

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

Authorized official

Name

Rick Johns

Title

Practice Administrator

Phone

(602) 850-8913

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pueblo Family Physicians LTD Doing business as

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

Part of

Pueblo Family Physician

Locations

Practitioners 18

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

• Donald G Cunningham, D.O.

  • Family Medicine Physician
  • Scottsdale, AZ
  • NPI 1508855719
  Medicare reassignment Care Compare group NPD
• Douglas L Cunningham, D.O.

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1104856475
  Medicare reassignment Care Compare group NPD
• Adam Esquer, NP

  • General Practice Physician
  • Phoenix, AZ
  • NPI 1073476032
  Medicare reassignment Care Compare group NPD
• Patricia Li, NP

  • Family Nurse Practitioner
  • Scottsdale, AZ
  • NPI 1003579830
  Medicare reassignment Care Compare group NPD
• Carlos Armando Perez, PA-C

  • Medical Physician Assistant
  • Phoenix, AZ
  • NPI 1457245953

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Phillip Prusinski, FNP

  • Family Nurse Practitioner
  • Phoenix, AZ
  • NPI 1033661244
  Medicare reassignment Care Compare group NPD
• Scott Sabish

  • Family Nurse Practitioner
  • Phoenix, AZ
  • NPI 1497128680
  Medicare reassignment Care Compare group NPD
• Alfredo M Flores, FNP-C

  • Nurse Practitioner
  • Phoenix, AZ
  • NPI 1750913810
  Medicare reassignment Care Compare group
• Deborah Locke, PA

  • Physician Assistant
  • Tempe, AZ
  • NPI 1942637103
  Medicare reassignment
• Thomas Joel Sirrine, P.A.-C

  • Physician Assistant
  • Phoenix, AZ
  • NPI 1689900276
  Medicare reassignment
• Jeffrey Allan Copoloff, DPM

  • Foot & Ankle Surgery Podiatrist
  • Phoenix, AZ
  • NPI 1164461802
  NPD (past)
• Grant T Fankhauser, M.D.

  • Vascular Surgery Physician
  • Peoria, AZ
  • NPI 1831121532

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707436800000",
    "number": "1790798072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 N 19TH AVE STE 6",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850154602",
            "telephone_number": "602-850-8913",
            "fax_number": "602-532-2956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 N 19TH AVE",
            "address_2": "SUITE 6",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850154602",
            "telephone_number": "602-264-9191",
            "fax_number": "602-532-2973"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15425 N Greenway Hayden Loop Ste A300",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852601204",
            "country_code": "US",
            "telephone_number": "480-607-1124",
            "fax_number": "480-607-1087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PUEBLO FAMILY PHYSICIANS LTD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PUEBLO FAMILY PHYSICIANS LTD",
        "enumeration_date": "2006-08-15",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A",
        "authorized_official_last_name": "JOHNS",
        "authorized_official_first_name": "RICK",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "602-850-8913"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "2325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "423779",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pueblo Family Physicians LTD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Public Safety Crisis Solutions, LLC
• Andrew Pucci
• Elizabeth Puckerin
• Harsha Choudary Pudhota
• Perla Eduwiges Puebla, NP
• Pueblo Radiology, LLC
• Lysbeth Puente
• Marcos C. Puente, PHARMD
• Sarah Elizabeth Puente, DC
• Synthia Puffenberger, PH.D.

• Family Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; 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.