District Medical Group, Inc
Organization Active NPI Endocrinology, Diabetes & Metabolism Physician · Phoenix, AZ
NPI 1992038004 · NPPES record last updated Oct 1, 2014
Key facts
- NPI
- 1992038004
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician 207RE0101X
- Legal business name
- DISTRICT MEDICAL GROUP, INC
- Practice address
- 2525 E Roosevelt St
Med Clinic - Endocrinology
Phoenix, AZ 85008-4948 - Phone
- (602) 344-1174
- NPI assigned
- Sep 9, 2009
- Organization subpart
- Yes
- Parent organization (as reported)
- DISTRICT MEDICAL GROUP, INC
Authorized official
- Name
- Teresa Cordeiro
- Title
- Credentialing Director
- Phone
- (602) 470-5000
Other NPIs on the same Medicare enrollment 23
Corporate family (same tax ID) 30
Practitioners 65
-
Ahmad Aldeiri, MD
-
Rebecca Altschuler, PHD
-
Janice Silva Angeles, D.O
-
Shannon Elizabeth Barker, D.O.
-
Patricia Beals, DMD
-
Marcia Bouton, PA-C
-
Evette S. Campos, FNP
-
Keng-Yu Chuang, M.D.
-
William James Cowden, M.D.
-
Patrick Harry David, M.D.
-
Stephanie Ellis, CRNP
-
Lauren Engler, MD
-
Shahan Fernando, M.D.
-
Kathleen A Galekovic, NPC
-
Kyle Matthew Greer, M.D.
-
Alexander R Harrison, M.D.
-
Prabodh Hemmady, MD
-
Kaisa T Jacobsen, NP
-
Kortni R Jones, PA-C
-
Mahmoud B Kabbani, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091125000583 | AZ | Part B Supplier - Clinic/Group Practice | 7315086691 |
Receives reassigned benefits from 1,603 practitioners 23 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Phoenix, AZ; Prescott, AZ; Scottsdale, AZ; Show Low, AZ; Sierra Vista, AZ; Sun City, AZ; Sun City West, AZ; Tucson, AZ… |
National Provider Directory
- Tax ID family
- District Medical Group Inc
- Part of
- District Medical Group Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endocrinology, Diabetes & Metabolism Physician |
207RE0101X | Yes |
Addresses
Primary practice location
2525 E Roosevelt St
Med Clinic - Endocrinology
Phoenix, AZ 85008-4948
Mailing address
2929 E Thomas Rd
Phoenix, AZ 85016-8034
Phone (602) 470-5000
Other providers in Phoenix, AZ
- District Medical Group, Inc
- District Medical Group, Inc
- District Medical Group, Inc
- District Medical Group, Inc
- District Medical Group, Inc
- Ditabell Behavioral Health Care LLC
- Michael James Ditsworth
- Sheeba Kalappurakkal Divakaran
- Maribeth Diver
- Divergent Collective, Inc.
All providers in Phoenix, AZ · Endocrinology, Diabetes & Metabolism Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 1, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.