DISTRICT MEDICAL GROUP, INC (NPI# 1174856280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174856280 |
| Entity Type | Organization |
| Organization Name | DISTRICT MEDICAL GROUP, INC |
| Practice Address |
2525 E Roosevelt St Med Clinic - Infectious Disease Phoenix AZ 85008-4948 |
| Mailing Address |
2929 E Thomas Rd Phoenix AZ 85016-8034 |
| Practice Telephone | 6023441095 |
| Mailing Telephone | 6024705000 |
| Enumeration Date | 2009-09-09 |
| Last Update Date | 2017-06-22 |
| Authorized Official Name | TERESA CORDEIRO (CREDENTIALING DIRECTOR) |
| Authorized Official Telephone | 6024705000 |
| Is Organization Subpart | Y |
| Parent Organization Name | DISTRICT MEDICAL GROUP, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers | ||
| N | 124Q00000X | Dental Hygienist | Dental Providers | ||
| N | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124667555 | District Medical Group, Inc | Family Medicine | 15182 N 75th Ave Ste 180, Peoria, AZ 85381-4722 | 2020-01-02 |
| 1366081705 | District Medical Group, Inc | Family Medicine | 3624 W Anthem Way Ste C116, Anthem, AZ 85086-0457 | 2020-01-02 |
| 1831722768 | District Medical Group, Inc | Surgery | 14155 N 83rd Ave Ste A105, Peoria, AZ 85381-5640 | 2020-02-19 |
| 1144860016 | District Medical Group, Inc | Internal Medicine | 6315 E Main St, Mesa, AZ 85205-8953 | 2020-01-08 |
| 1063052934 | District Medical Group, Inc | Family Medicine | 1805 N Scottsdale Rd, Tempe, AZ 85281-1556 | 2020-01-08 |
| 1538708979 | District Medical Group, Inc | Family Medicine | 10144 W Lake Pleasant Pkwy Ste 1110, Peoria, AZ 85382-9716 | 2020-01-02 |
| 1548653934 | District Medical Group, Inc | Emergency Medicine | 2601 E Roosevelt St, Toxicology, Phoenix, AZ 85008-4973 | 2015-03-10 |
| 1144624339 | District Medical Group, Inc | Emergency Medicine | 2601 E Roosevelt St, Emergency Medicine, Phoenix, AZ 85008-4973 | 2014-10-16 |
| 1407106719 | District Medical Group, Inc | Clinic/Center | 3141 N 3rd Ave, Phoenix, AZ 85013-4345 | 2012-09-13 |
| 1538484993 | District Medical Group, Inc | Internal Medicine | 2601 E Roosevelt St, Rheumatology, Phoenix, AZ 85008-4973 | 2010-03-29 |
| Street Address |
2525 E ROOSEVELT ST MED CLINIC - INFECTIOUS DISEASE |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85008-4948 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083698955 | Surabhi Amar | Internal Medicine | 2525 E Roosevelt St, Phoenix, AZ 85008-4948 | 2005-12-02 |
| 1982202982 | Katherine Brown | Dietitian, Registered | 2525 E Roosevelt St, Phoenix, AZ 85008-4948 | 2020-10-12 |
| 1295360287 | Stephanie Nicole Steeves | Dietitian, Registered | 2525 E Roosevelt St, Phoenix, AZ 85008-4948 | 2020-03-10 |
| 1154967602 | Danielle Fleck | Occupational Therapist | 2525 E Roosevelt St, Phoenix, AZ 85008-4948 | 2019-11-19 |
| 1336614858 | Teresa Dejesus Loera | Registered Nurse | 2525 E Roosevelt St, Phoenix, AZ 85008-4948 | 2018-10-11 |
| 1518445519 | Ari Blechner | Counselor | 2525 E Roosevelt St, Phoenix, AZ 85008-4948 | 2018-08-01 |
| 1194211755 | Adrienne Anne Jean Robb | Student in an Organized Health Care Education/Training Program | 2525 E Roosevelt St, Phoenix, AZ 85008-4948 | 2018-07-06 |
| 1629575246 | Andrea Jeanne Klock | Nurse Practitioner | 2525 E Roosevelt St, Phoenix, AZ 85008 | 2018-04-10 |
| 1003320904 | Sarah Taraborelli | Physician Assistant | 2525 E Roosevelt St, Phoenix, AZ 85008-4948 | 2017-11-30 |
| 1538680079 | Tessa Bowie | Physician Assistant | 2525 E Roosevelt St, Phoenix, AZ 85008-4948 | 2017-07-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821607060 | Am Apnea and Tmj LLC | Durable Medical Equipment & Medical Supplies | 2303 N. 44thst., Suite 14-1008, Phoenix, AZ 85008 | 2020-07-23 |
| 1194341131 | Abdulbaril Olandapo Olagunju | Student in an Organized Health Care Education/Training Program | 2601 E Roosevelt Street, Valleywise Health, Phoenix, AZ 85008 | 2020-06-24 |
| 1376164632 | Abdul Rahman Raed Mustafa Halawa | Student in an Organized Health Care Education/Training Program | 2601 E Roosevelt St Valleywise Health, Phoenix, AZ 85008 | 2020-04-28 |
| 1245869460 | Zachary Masuda | Student in an Organized Health Care Education/Training Program | Valleywise Health Medical Center, 2601 E Roosevelt St, Phoenix, AZ 85008 | 2020-04-08 |
| 1942840145 | Cana Behavior LLC | Physical Therapist | 2412 N 36 Pl, Phoenix, AZ 85008 | 2020-01-15 |
| 1871158188 | Fred Gardezy | Student in an Organized Health Care Education/Training Program | Maricopa Integrated Health System 2601 E. Roosevelt St., Phoenix, AZ 85008 | 2019-05-02 |
| 1225692346 | Navkaran Singh Girgla | Student in an Organized Health Care Education/Training Program | 2601 East Roosevelt St., Phoenix, AZ 85008 | 2019-04-24 |
| 1316412323 | Southwest Human Developement | Early Intervention Provider Agency | 2850 N 24h Street, Phoenix, AZ 85008 | 2018-10-05 |
| 1558885970 | Mona Ridhwan Ziems | Midwife | 1919 N 31st St, Phoenix, AZ 85008 | 2017-07-27 |
| 1093244451 | Shana Cynamon | Audiologist | 1801 N 37th Pl, Phoenix, AZ 85008 | 2017-06-08 |
| Find all providers in zip 85008 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144746033 | Az Surgical Solutions | Surgery | 3724 N 3rd St Ste 302, Phoenix, AZ 85012-2034 | 2017-08-22 |
| 1184072894 | Eugene L De La Cruz Dpm PC | Surgery | 1743 W Sienna Bouquet Pl, Phoenix, AZ 85085-8040 | 2016-06-03 |
| 1164821112 | Arizona Surgical Associates, Plc | Surgery | 9305 W Thomas Rd Ste 480, Phoenix, AZ 85037-3375 | 2014-08-15 |
| 1639443096 | Joseph Patrick Kennelly | Surgery | 5941 E Lafayette Blvd, Phoenix, AZ 85018-4660 | 2012-03-02 |
| 1285927574 | Para Surgical Specialists, Pllc | Surgery | 9515 W. Camelback Rd, Suite 132, Phoenix, AZ 85037-0000 | 2011-05-19 |
| 1427347665 | Morley Rosenfield | Surgery | 3039 E Marshall Ave, Phoenix, AZ 85016-3713 | 2011-03-28 |
| 1962705889 | Richard Lance Chilian | Surgery | 2539 West Bloch Road, Phoenix, AZ 85041-2908 | 2010-12-15 |
| 1205140027 | Tracy Lynn Freeborn | Surgery | 9250 W Thomas Rd Ste 250, Phoenix, AZ 85037 | 2010-08-04 |
| 1407176126 | Martin E. Zipser | Surgery | 7320 N Dreamy Draw Dr, Phoenix, AZ 85020-5212 | 2010-06-03 |
| 1649413089 | Kaavya Reddy Matatova | Surgery | 19646 N 27th Ave Ste 201, Phoenix, AZ 85027-4026 | 2009-04-15 |
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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.