M. L. Erickson, MD, LLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

28384 Issued in AZ

Legal business name

M. L. ERICKSON, MD, LLC

Practice address

6370 W Union Hills Dr
Glendale, AZ 85308-7136

Phone

(623) 414-3500

Fax

(623) 455-9214

NPI assigned

Mar 6, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Marvin L Erickson, MDNPI 1679569776

Title

President

Phone

(623) 414-3500

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 6

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.

• Marvin L Erickson, M.D.

  • Obstetrics & Gynecology Physician
  • Glendale, AZ
  • NPI 1679569776
  Medicare reassignment Care Compare group Authorized official
• Luminita Iacob, PA

  • Physician Assistant
  • Phoenix, AZ
  • NPI 1477535433
  Medicare reassignment Care Compare group
• Danielle Fladhammer, CNM

  • Advanced Practice Midwife
  • Glendale, AZ
  • NPI 1053075614
  Medicare reassignment NPD
• Erron Laskin Kinsler, MD

  • Obstetrics & Gynecology Physician
  • Manchester, NH
  • NPI 1194827469

  AZ

  Medicare reassignment NPD
• Tiffany Michelle Janes, PA-C

  • Physician Assistant
  • Phoenix, AZ
  • NPI 1912473182
  Medicare reassignment
• Saul Moroni Rivera, PA

  • Physician Assistant
  • Phoenix, AZ
  • NPI 1821508938
  Medicare reassignment

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

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515628800000",
    "number": "1851561732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6370 W UNION HILLS DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853087136",
            "telephone_number": "623-414-3500",
            "fax_number": "623-455-9214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6370 W UNION HILLS DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853087136",
            "telephone_number": "623-414-3500",
            "fax_number": "623-455-9214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M. L. ERICKSON, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-06",
        "last_updated": "2018-01-11",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "623-414-3500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "28384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "28384",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "512774",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hope Lyons
• Melinda Lyons, COTA/L
• Pawel Lysikowski, MD
• M-Tee-S Mobile Medical Services
• M-Tee's Mobile Medical Services
• M&M Medical Transportation
• M&M Medical Transportation LLC
• Chung Woon Ma, PHARMD, BCPS
• Daisy Ma, PHARM.D
• Stacy Maahs, FNP-C

• Obstetrics & Gynecology Physician in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Obstetrics & Gynecology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2018; 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.