Michelle Obillo Prestoza, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

55931 Issued in AZ

Practice address

13640 N Plaza del Rio Blvd
Peoria, AZ 85381-4846

Phone

(623) 876-3830

Fax

(623) 285-2608

NPI assigned

Apr 3, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Banner Primary Care Physicians Arizona LLCGroup PAC ID 6406020155, 236 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Emblem Home Health Phoenix Home health agency, Phoenix, AZ, CCN 037438
• Banner Home Care-Arizona Home health agency, Mesa, AZ, CCN 037015
• Banner del E. Webb Medical Center Hospital, Sun City West, AZ, CCN 030093

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Banner Primary Care Physicians Arizona LLC

  • Primary Care Clinic/Center
  • Phoenix, AZ
  • NPI 1659640902
  Medicare reassignment Care Compare group NPD
• Banner Primary Care Physicians Arizona LLC

  • Clinical Medical Laboratory
  • Peoria, AZ
  • NPI 1649544362
  NPD
• Banner Primary Care Physicians Arizona LLC

  • Primary Care Clinic/Center
  • Phoenix, AZ
  • NPI 1790306066
  NPD
• Banner Primary Care Physicians Arizona LLC

  • Primary Care Clinic/Center
  • Phoenix, AZ
  • NPI 1417238908
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Banner del E Webb Medical Center

  • General Acute Care Hospital
  • Sun City West, AZ
  • NPI 1588823553
  Care Compare affiliation
• Banner Home Care-Arizona

  • Home Health Agency
  • Sun City, AZ
  • NPI 1023051927
  Care Compare affiliation
• Rock Garden Healthcare LLC

  dba Emblem Home Health Phoenix

  • Home Health Agency
  • Phoenix, AZ
  • NPI 1033715222
  Care Compare affiliation

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

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539820800000",
    "number": "1831584044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13640 N PLAZA DEL RIO BLVD STE 210",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13640 N PLAZA DEL RIO BLVD",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814846",
            "telephone_number": "623-876-3830",
            "fax_number": "623-285-2608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTOZA",
        "first_name": "MICHELLE",
        "middle_name": "OBILLO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-03",
        "last_updated": "2018-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "55931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premere Rehab LLC (Infinity Rehab)
• Premier Pain & Wellness
• Premiere Medical Care PLLC
• Premium Comfort Care LLC (Premium Comfort Care)
• Karen Prentice, D.O.
• Addie Price, PHARMD
• Jaeana Z Price, LPN
• Primova Health LLC
• Prince of Peace Assisting Living
• Breana R Prince, P.T., D.P.T

• Family Medicine Physician in Peoria, AZ
• Providers in Peoria, 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 Oct 18, 2018; 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.

Verify at the official NPI Registry.