PETER NIEMCZYK MD FACS LLC (NPI# 1215119524) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215119524 |
| Entity Type | Organization |
| Organization Name | PETER NIEMCZYK MD FACS LLC |
| Practice Address |
5171 Cub Lake Rd Suite C340 Show Low AZ 85901-7888 |
| Mailing Address |
20325 N 51st Ave Suite 102 Glendale AZ 85308-5674 |
| Practice Telephone | 9285370111 |
| Practice Fax Number | 6235839666 |
| Mailing Telephone | 6237802300 |
| Mailing Fax Number | 6235839666 |
| Enumeration Date | 2007-11-28 |
| Last Update Date | 2010-05-21 |
| Authorized Official Name | DR. PETER NIEMCZYK (DIRECTOR) |
| Authorized Official Telephone | 6237802300 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 34718 | AZ | Allopathic & Osteopathic Physicians |
| Street Address |
5171 CUB LAKE RD SUITE C340 |
| City | SHOW LOW |
| State | AZ |
| Zip Code | 85901-7888 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588660997 | Michelle M Mulder | Specialist | 5171 Cub Lake Rd, Suite B210, Show Low, AZ 85901-7888 | 2005-06-22 |
| 1538510573 | Luke Wahlstrom | Physical Therapist | 5171 Cub Lake Rd, Suite C310, Show Low, AZ 85901-7888 | 2016-06-30 |
| 1467878108 | Summit Healthcare Medical Associates | Internal Medicine | 5171 Cub Lake Rd, Suite B230, Show Low, AZ 85901-7888 | 2014-03-05 |
| 1831472729 | Vance Patrick Hoopes | Physical Therapist | 5171 Cub Lake Rd, Suite C 360, Show Low, AZ 85901-7888 | 2011-09-27 |
| 1124356274 | Kathy A Daley | Physical Therapist | 5171 Cub Lake Rd, Suite C 360, Show Low, AZ 85901-7888 | 2009-12-01 |
| 1568790616 | Steven E Kempton | Physical Therapist | 5171 Cub Lake Rd, Suite C 360, Show Low, AZ 85901-7888 | 2009-12-01 |
| 1821326224 | Robins Nest Pediatrics, Pllc | Specialist | 5171 Cub Lake Rd, Ste B280, Show Low, AZ 85901-7888 | 2009-11-23 |
| 1740432590 | University Ob-gyn, LLC | Obstetrics & Gynecology | 5171 Cub Lake Rd, Bldg B #210, Show Low, AZ 85901 | 2008-10-10 |
| 1881860252 | John Dallas Davis | Physical Therapist | 5171 Cub Lake Rd, Suite C- 360, Show Low, AZ 85901-7888 | 2008-05-05 |
| 1063694271 | Elizabeth J Finan | Physical Therapist | 5171 Cub Lake Rd, Suite C-360, Show Low, AZ 85901-7888 | 2007-11-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811468804 | Summit Healthcare Association | Pharmacy | 4951 South White Mountain Road, Bldg A., Suite 1500, Show Low, AZ 85901 | 2018-12-17 |
| 1821446386 | Ivy L Loney | Social Worker | 580 E. Old Linden Rd #6, Show Low, AZ 85901 | 2016-05-25 |
| 1750749214 | Summit Healthcare | General Acute Care Hospital | 181 East Sylvester, Show Low, AZ 85901 | 2016-01-29 |
| 1194153916 | Alpha & Omega Physical Therapy Acc | Physical Therapist | 861 E Cooley St # B, Show Low, AZ 85901 | 2013-10-15 |
| 1033454707 | North Country Healthcare, Inc. | Family Medicine | 2600 E. Show Low Lake Rd., Show Low, AZ 85901 | 2012-12-06 |
| 1073740098 | North Country Healthcare, Inc. | Clinic/Center | 2650 E. Show Low Lake Rd, Suite 1, Show Low, AZ 85901 | 2009-06-17 |
| 1215174768 | Coast To Coast Air Ambulance, LLC | Ambulance | 3151 Airport Loop Ste 2, Show Low, AZ 85901 | 2009-01-20 |
| 1487899712 | Akdhc, LLC | Internal Medicine | 2051 Evergreen Lane, Ste D, Your Family Practice Team, Show Low, AZ 85901 | 2008-12-16 |
| 1851553192 | Health Angels Companion Care, Inc. | Technician | 1001 E. Huning, Show Low, AZ 85901 | 2008-06-27 |
| 1528231586 | Peggy Johnson | Occupational Therapist | Cusd# 24 Hwy 191, Chinle, AZ 85901 | 2008-04-10 |
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| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518953041 | Peter Niemczyk | Urology | 5171 Cub Lake Rd, Bldg C Ste 340, Show Low, AZ 85901-7888 | 2005-09-20 |
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|---|---|---|---|---|
| 1245831379 | Thayne R Larson | Urology | 11900 N 102nd St, Scottsdale, AZ 85260-5928 | 2020-11-04 |
| 1386250835 | Urosouth Pllc | Urology | 6369 E Tanque Verde Rd Ste 160, Tucson, AZ 85715-3833 | 2020-09-21 |
| 1689286049 | Urosouth Pllc | Urology | 5240 E Knight Dr Ste 108, Tucson, AZ 85712-2122 | 2020-08-18 |
| 1558824763 | Kyle Scott Garcia | Urology | 1501 N Campbell Ave Rm 5325, Tucson, AZ 85724-0001 | 2019-04-14 |
| 1154886109 | Arizona Institute of Urology Pllc | Urology | 1521 E Tangerine Rd Ste 209, Oro Valley, AZ 85755-6218 | 2019-02-04 |
| 1427513472 | Arizona Institute of Urology Pllc | Urology | 395 N Silverbell Rd Ste 315, Tucson, AZ 85745-2980 | 2019-02-04 |
| 1881159838 | Arizona Institute of Urology Pllc | Urology | 516 E Whitehouse Canyon Rd Ste 160, Green Valley, AZ 85614-0543 | 2019-02-04 |
| 1558879759 | Alliance Oncology of Arizona, LLC | Urology | 2525 E Arizona Biltmore Cir Ste C236, Phoenix, AZ 85016-2130 | 2018-01-22 |
| 1659780583 | Wilfred Morris Potter | Urology | 10801 E. Happy Valley Road, #74, Scottsdale, AZ 85255 | 2014-08-05 |
| 1912327198 | Kris Miguel Cajipe | Urology | 15920 S 48th St Ste 100, Phoenix, AZ 85048-1003 | 2014-04-25 |
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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.