DR. TRACI E. JENSEN (NPI# 1053595041) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053595041 |
| Entity Type | Individual |
| Full Name | DR. TRACI E. JENSEN |
| Credential | D.O. |
| Practice Address |
28471 N Vistancia Blvd Ste 102 Peoria AZ 85383-2092 |
| Practice Telephone | 6233278800 |
| Mailing Telephone | 6233278800 |
| Mailing Fax Number | 6233278801 |
| Enumeration Date | 2007-12-26 |
| Last Update Date | 2020-01-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 4815 | AZ | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | R927 | AZ | Student, Health Care |
| Street Address |
28471 N VISTANCIA BLVD STE 102 |
| City | PEORIA |
| State | AZ |
| Zip Code | 85383-2092 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598743478 | John Gabriel Sarmiento | Pediatrics | 28471 N Vistancia Blvd Ste 102, Peoria, AZ 85383 | 2006-01-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831701218 | West Point Optical Group | Optometrist | 24775 N. Pleasant Pkwy, Peoria, AZ 85383 | 2020-08-18 |
| 1528694247 | Lake Pleasant Kids Dentists and Orthodontics, LLP | Dentist | 24775 North Lake Pleasant Parkway Suite 104, Peoria, AZ 85383 | 2020-03-13 |
| 1124502273 | Nicole Angelina Hennigan | Registered Nurse | 9710 W. Happy Valley Rd, Suite 100 (salon 16), Peoria, AZ 85383 | 2018-09-24 |
| 1962994012 | Reach for The Stars Pediatric Therapy Pllc | Physical Therapy Assistant | 8662 W Lariat Ln, Peoria, AZ 85383 | 2018-06-05 |
| 1013417617 | Elite Infusions LLC | Internal Medicine | 10252 W Villa Chula, Peoria, AZ 85383 | 2018-02-20 |
| 1427577238 | Serene Valley Care LLC | Assisted Living Facility | 29751 N 119th Lane, Peoria, AZ 85383 | 2017-09-12 |
| 1255857827 | Advanced Air Amulance LLC | Ambulance | 9463 West El Cortez Place, Peoria, AZ 85383 | 2017-08-16 |
| 1427578996 | Paul R Arthur | Physical Therapist | 9745 W. Happy Valley Rd, Peoria, AZ 85383 | 2017-06-26 |
| 1528597143 | Lucy Denton | Specialist/Technologist | 9234 West Andrea Drive, Peoria, AZ 85383 | 2017-06-07 |
| 1801263579 | John Leano | Pharmacist | 26898 N 87th Dr, Peoria, AZ 85383 | 2015-08-28 |
| Find all providers in zip 85383 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922621739 | Titan Medical LLC | Family Medicine | 13660 N 94th Dr Ste D-3, Peoria, AZ 85381-4836 | 2020-05-27 |
| 1619516788 | Michelle Martin | Family Medicine | 15182 N 75th Ave # Uint180, Peoria, AZ 85381-4722 | 2020-01-06 |
| 1124667555 | District Medical Group, Inc | Family Medicine | 15182 N 75th Ave Ste 180, Peoria, AZ 85381-4722 | 2020-01-02 |
| 1831693514 | Summa Health Care, PC | Family Medicine | 8877 W Union Hills Dr Ste 240, Peoria, AZ 85382 | 2018-03-19 |
| 1992236848 | Agape Primary Care, Pllc | Family Medicine | 8380 W Emile Zola Ave # 5178, Peoria, AZ 85381-4811 | 2017-03-22 |
| 1043666910 | Honorhealth Medical Group, LLC | Family Medicine | 10230 W Happy Valley Rd, Ste100, Peoria, AZ 85383-2795 | 2016-05-10 |
| 1598160863 | Healthcare Partners Arizona Medical Group LLC | Family Medicine | 16155 N 83rd Ave Ofc, #201, Peoria, AZ 85382-5815 | 2014-10-29 |
| 1164856506 | Charlotte Christie Clayton | Family Medicine | 7505 N Edgewild Dr, Peoria, IL 61614-2117 | 2013-08-21 |
| 1770824112 | Dean Robert Bordeaux | Family Medicine | 7614 N Patton Ln, Peoria, IL 61614-1828 | 2013-03-11 |
| 1467731935 | James Austin Shane Jr. | Family Medicine | 18821 N 94th Ave, Peoria, AZ 85382-3697 | 2011-08-15 |
| Find all providers in PEORIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.