JESSICA MICHELE BERDEJA (NPI# 1215190749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215190749 |
| Entity Type | Individual |
| Full Name | JESSICA MICHELE BERDEJA |
| Other Name | JESSICA YBARRA |
| Credential | MD |
| Practice Address |
9225 N 3rd St Suite 103 Phoenix AZ 85020-2439 |
| Mailing Address |
2500 W Utopia Rd Suite 100 Phoenix AZ 85027-4171 |
| Practice Telephone | 6029063500 |
| Practice Fax Number | 6029063519 |
| Mailing Telephone | 6234346200 |
| Mailing Fax Number | 6234346164 |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2016-01-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
46095 | AZ | Allopathic & Osteopathic Physicians |
| N | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
A115734 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
9225 N 3RD ST SUITE 103 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85020-2439 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740273911 | Mario F Avila | Internal Medicine | 9225 N 3rd St, Ste 300, Phoenix, AZ 85020-2466 | 2005-08-23 |
| 1669910840 | Diane Lydia King | Social Worker | 9225 N 3rd St, Suite 103, Phoenix, AZ 85020-2439 | 2017-02-07 |
| 1356727358 | Cynapse, Pllc | Specialist/Technologist, Other | 9225 N 3rd St, Ste 100, Phoenix, AZ 85020-2439 | 2015-08-03 |
| 1275965402 | Matthew Roland Degarlais | Internal Medicine | 9225 N 3rd St, Suite 300, Phoenix, AZ 85020-2439 | 2013-07-30 |
| 1417396144 | Kimberly Linnae Collier | Internal Medicine | 9225 N 3rd St, Suite 300, Phoenix, AZ 85020-2439 | 2013-06-16 |
| 1124467956 | John C. Lincoln North Mountain Professionals, LLC | Nurse Practitioner | 9225 N 3rd St, Suite 103, Phoenix, AZ 85020-2439 | 2013-06-14 |
| 1518304708 | Dru Dethlefs | Internal Medicine | 9225 N 3rd St, Suite 300, Phoenix, AZ 85020-2439 | 2013-05-28 |
| 1053652289 | Shannon Marie Brown | Nurse Practitioner | 9225 N 3rd St, Suite 300, Phoenix, AZ 85020-2439 | 2013-03-13 |
| 1174885859 | Kurtis Wayne Bradley | Internal Medicine | 9225 N 3rd St, Suite 300, Phoenix, AZ 85020-2439 | 2012-06-08 |
| 1407120421 | Evan Taylor Holdsworth | Internal Medicine | 9225 N 3rd St, #300, Phoenix, AZ 85020-2439 | 2012-03-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124683537 | Joseph A Jones | Pharmacist | 7543 N 20th St, Phoenix, AZ 85020 | 2019-05-01 |
| 1871022210 | Amber L Enright | Physical Therapist | 1675 E Morten Ave, 4155, Phoenix, AZ 85020 | 2017-06-08 |
| 1518407683 | Harmony Dental Partners, LLC | Dentist | 7150 North 7th Street, Phoenix, AZ 85020 | 2017-03-08 |
| 1104369495 | Michelle Mastro | Registered Nurse | 1234 E. Northern Avenue, Phoenix, AZ 85020 | 2016-11-18 |
| 1912363003 | Charles D. Atkinson | Social Worker | 1716 East Seldon Lane, Phoenix, AZ 85020 | 2016-01-06 |
| 1477928471 | Erin Testa | Psychologist | 7600 N 16th St Ste 218, Phoenix, AZ 85020 | 2015-12-02 |
| 1972977569 | Borpan Monitoring, Pllc | Psychiatry & Neurology | 7000 N 16th Street Ste 120 # 281, Phoenix, AZ 85020 | 2015-11-19 |
| 1275906984 | Summer Macey | Nurse Practitioner | 9225 N. 3rd St #304, Affiliated Hospitalists, Phoenix, AZ 85020 | 2015-11-03 |
| 1356712772 | Maurie S Comenzo | Clinic/Center | 11024 North 28th Drive/suite #200, Lake Biltmore Corporate Center, Phoenix, AZ 85020 | 2015-10-12 |
| 1700260692 | Stansberry Family Dentistry Pllc | Dentist | 7501 N. 16th St. #100, Phoenix, AZ 85020 | 2015-07-10 |
| Find all providers in zip 85020 | ||||
| Taxonomy Code | 207QG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Geriatric Medicine |
| A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://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 Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073148326 | Team Select Mobile Physicians Az LLC | Family Medicine | 2999 N 44th St Ste 110, Phoenix, AZ 85018-7247 | 2020-03-06 |
| 1366796773 | Medical Group of Arizona, LLC | Family Medicine | 13430 N. Black Canyon Highway, Suite 100, Phoenix, AZ 85029-1310 | 2012-11-07 |
| 1851612329 | Lake Mi Mobile Doctors, P.C. | Family Medicine | 2345 E. Thomas Rd, Suite # 420, Phoenix, AZ 85016 | 2010-06-18 |
| 1265617013 | Shelly R Myers | Family Medicine | 4520 N 12th St, Suite #103, Phoenix, AZ 85014-4233 | 2007-12-28 |
| 1225236367 | Thomas J Cuomo Jr Md PC | Family Medicine | 13835 N Tatum Blvd # 9468, Phoenix, AZ 85032-5581 | 2007-07-10 |
| 1225132608 | Sona S Giknavorian | Family Medicine | 2345 E Thomas Rd Ste 420, Suite # 420, Phoenix, AZ 85016-7862 | 2006-09-07 |
| 1598702086 | Robin F Macdougall | Family Medicine | 4626 E. Shea Blvd, Suite C230, Phoenix, AZ 85028 | 2006-06-01 |
| 1205812757 | Thomas J Cuomo Jr | Family Medicine | 13835 N Tatum Blvd, 9615, Phoenix, AZ 85032-5581 | 2005-12-16 |
| 1710255088 | Mh7, LLC | Family Medicine | 4520 N 12th St, Suite 103, Phoenix, AZ 85014-4233 | 2011-12-01 |
| 1861624702 | John C. Lincoln, LLC | Family Medicine | 1668 W Glendale Ave, Suite 128, Phoenix, AZ 85021-8948 | 2009-08-11 |
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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.