DR. ELIJAH MICHAEL POULOS (NPI# 1386871325) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386871325 |
| Entity Type | Individual |
| Full Name | DR. ELIJAH MICHAEL POULOS |
| Credential | MD |
| Practice Address |
1200 N Beaver St Flagstaff AZ 86001 |
| Mailing Address |
Po Box 967 Flagstaff AZ 86002-0967 |
| Practice Telephone | 9287730003 |
| Practice Fax Number | 9287731170 |
| Mailing Telephone | 9287730003 |
| Mailing Fax Number | 9287731170 |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2019-10-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | R71506 | AZ | Allopathic & Osteopathic Physicians |
| Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
46193 | AZ | Allopathic & Osteopathic Physicians |
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
46193 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 026439 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1360 N Rim Dr, Flagstaff, AZ 860013111 | 9287748000 | 9287740372 |
| 823 N San Francisco St Ste G1, Flagstaff, AZ 860013253 | 9287748000 | 9287740372 |
| Street Address |
1200 N BEAVER ST |
| City | FLAGSTAFF |
| State | AZ |
| Zip Code | 86001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346241189 | Alvin B Elisco | Internal Medicine | 1200 N Beaver St, Fmc Hospitalists, Flagstaff, AZ 86001-3118 | 2005-08-02 |
| 1285240515 | Amika Noel | Nurse Anesthetist, Certified Registered | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-09-22 |
| 1669084190 | Margaret Grace Mcgough | Registered Nurse | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-08-17 |
| 1942818398 | Regan Rowson | Registered Nurse | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-07-21 |
| 1871118984 | Nancy Gloria Flores | Audiologist | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-06-15 |
| 1679100705 | Kristy Anderson | Occupational Therapist | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-03-26 |
| 1164058087 | Bryan J Ebeling | Nurse Practitioner | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-03-23 |
| 1447808407 | Bryce Aldworth Randall | Registered Nurse | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2019-09-03 |
| 1851952162 | Samuel Small | Nurse Practitioner | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2019-06-26 |
| 1235797283 | Rebecca R Boger | Dietitian, Registered | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2019-06-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658756 | Marlenne Adair Escobar-mendoza | Specialist/Technologist | 1705 South San Francisco Street, Flagstaff, AZ 86001 | 2020-10-27 |
| 1962033712 | Laura-lee Prescott | Social Worker | Northern Az Va Healthcare System, Flagstaff Cboc, 1300 W. University Ave., Suite 300, Flagstaff, AZ 86001 | 2020-01-30 |
| 1194360784 | Trinity Medical Consultants Pllc | Internal Medicine | 1521 N Cliff Drive, Flagstaff, AZ 86001 | 2019-11-07 |
| 1154849610 | Altacare, LLC | Family Medicine | 2700 S Woodlands Village Blvd Ste 700, Flagstaff, AZ 86001 | 2017-09-05 |
| 1487174926 | Lindsey Marie Forstie | Nurse Practitioner | 7263 E Dreamview Trail, Flagstaff, AZ 86001 | 2017-06-26 |
| 1255860763 | Welbrook Senior Living Flagstaff LLC | Skilled Nursing Facility | 1521 N Pine Cliff Dr, Flagstaff, AZ 86001 | 2017-06-08 |
| 1912432675 | Ryan Tiscareno | Specialist/Technologist | 621 West Cherry Ave, Flagstaff, AZ 86001 | 2017-05-01 |
| 1629432380 | Behavioral Consultation Services, Inc. | Clinic/Center | 345 S. River Run Road, Suite 200, Flagstaff, AZ 86001 | 2016-04-08 |
| 1275920928 | Junli Gallagher | Speech-Language Pathologist | 1215 N. Beaver St, Flagstaff, AZ 86001 | 2015-04-21 |
| 1932592599 | Kristen Flugstad Psyd, LLC | Psychologist | 125 East Elm Avenue #203, Flagstaff, AZ 86001 | 2015-03-06 |
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| Taxonomy Code | 207RC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Critical Care Medicine |
| An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| 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 Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386955623 | Lisa Ann Graham | Internal Medicine | 1200 N Beaver St, Flagstaff, AZ 86001 | 2010-07-01 |
| 1609950500 | Michael F Reidy | Internal Medicine | 1200 N Beaver St, Flagstaff, AZ 86001 | 2006-10-25 |
| 1548350168 | Ernst-gilbert Schreiber | Internal Medicine | 1200 N Beaver St, Flagstaff, AZ 86001 | 2006-10-13 |
| 1811094931 | Critical Care Consultants of Arizona Pllc | Internal Medicine | 1200 N Beaver St, Flagstaff, AZ 86001 | 2006-09-20 |
| 1225079635 | Brent M Cutshall | Internal Medicine | 1200 N Beaver St, Flagstaff, AZ 86001 | 2006-06-09 |
| 1437122108 | Theodore H Lewis Jr. | Internal Medicine | 1200 N Beaver St, Flagstaff, AZ 86002 | 2006-02-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326661851 | Intensivists of Arizona, LLC | Internal Medicine | 6970 E Chauncey Ln Ste 105, Phoenix, AZ 85054-5158 | 2020-05-19 |
| 1841854767 | Mahafzah Pllc | Internal Medicine | 14618 W Hidden Terrace Loop, Litchfield Park, AZ 85340-0992 | 2019-04-25 |
| 1992277818 | Nedali 99, LLC | Internal Medicine | 5401 E Mockingbird Ln, Paradise Valley, AZ 85253-2523 | 2018-12-18 |
| 1154844645 | Alp Umar Md Plc | Internal Medicine | 15029 N Thompson Peak Pkwy Ste B111-480, Scottsdale, AZ 85260-2217 | 2017-07-17 |
| 1114345345 | Ordessia Charran | Internal Medicine | 1739 E Beverly Ave Ste 203, Kingman, AZ 86409-3593 | 2014-04-04 |
| 1639517949 | Amr Ibrahim El Maghraby | Internal Medicine | 111 E Dunlap Ave Ste I-279, Phoenix, AZ 85020-2807 | 2013-06-08 |
| 1649537473 | Arizona Pulmonary & Sleep, Inc | Internal Medicine | 6320 W Union Hills Dr Ste A205, Glendale, AZ 85308-1096 | 2012-04-18 |
| 1841523545 | Spyros Kamarinos | Internal Medicine | 111 E Dunlap Ave Ste 1-482, Phoenix, AZ 85020-7806 | 2009-09-12 |
| 1356573000 | Drsm, PC | Internal Medicine | 16601 N. 40th St, Suite 101, Phoenix, AZ 85032 | 2009-08-13 |
| 1215168059 | Sathish Sanna | Internal Medicine | 14506 W Granite Valley Dr Ste 113, Sun City West, AZ 85375 | 2009-07-28 |
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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.