PHOENIX OCULOPLASTIC CONSULTANTS, PLLC (NPI# 1497009641) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497009641 |
| Entity Type | Organization |
| Organization Name | PHOENIX OCULOPLASTIC CONSULTANTS, PLLC |
| Practice Address |
3410 N 4th Ave Phoenix AZ 85013-3905 |
| Mailing Address |
4340 E Indian School Rd Suite 21-440 Phoenix AZ 85018-5360 |
| Practice Telephone | 6022571499 |
| Practice Fax Number | 4803613517 |
| Mailing Telephone | 6022571498 |
| Mailing Fax Number | 4803613517 |
| Enumeration Date | 2012-11-08 |
| Last Update Date | 2012-11-08 |
| Authorized Official Name | DR. MISHA FAUSTINA (MANAGER) |
| Authorized Official Telephone | 6022571498 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207W00000X | Ophthalmology | 33016 | AZ | Allopathic & Osteopathic Physicians |
| Y | 2082S0099X |
Plastic Surgery Specialization: Plastic Surgery Within the Head and Neck |
33016 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NPI | 1669438057 | 01 | |
| AZ | 608730 | 05 | |
| AZ | 868672 | 05 | |
| NPI | 1952570194 | 01 |
| Street Address |
3410 N 4TH AVE |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85013-3905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720070790 | Franklin D Loffer | Obstetrics & Gynecology | 3410 N 4th Ave, Phoenix, AZ 85013-3905 | 2005-08-16 |
| 1174946420 | Lindsey Purcelley | Nurse Practitioner | 3410 N 4th Ave, Phoenix, AZ 85013-3905 | 2014-01-22 |
| 1316050529 | Eugenie Virginia Anderson | Specialist | 3410 N 4th Ave, Phoenix, AZ 85013 | 2006-08-15 |
| 1376533943 | Michelle M Park | Internal Medicine | 3410 N 4th Ave, Phoenix, AZ 85013-3905 | 2005-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043833700 | Marco Antonio Valdez Espinoza | Student in an Organized Health Care Education/Training Program | 500 W. Thomas Road, Suite 900 A, Phoenix, AZ 85013 | 2020-05-28 |
| 1518588292 | Santiago Garcia Ortiz | Student in an Organized Health Care Education/Training Program | 350w Thomas Rd St. Joseph's Hospital and Medical Center, Phoenix, AZ 85013 | 2020-05-04 |
| 1356811970 | Lynne Shaunte Coleman | Nurse Practitioner | 3633 N 3rd Ave 2019, Phoenix, AZ 85013 | 2018-11-26 |
| 1467949156 | Solterra 3rd Indian School Operations, LLC | Assisted Living Facility | 4000 N 3rd Avenue, Phoenix, AZ 85013 | 2018-04-18 |
| 1083018345 | Romelda Antonio | Nurse Practitioner | 222 W Thomas Rd Ste 212, Phoenix, AZ 85013 | 2014-10-15 |
| 1760890131 | Emmitt Michael Thompson | General Practice | 822 West Earll Drive, Phoenix, AZ 85013 | 2014-07-29 |
| 1902218480 | Sreeja Biswas Roy | Internal Medicine | 350 W Thomas Road, Phoenix, AZ 85013 | 2014-06-02 |
| 1417381120 | Osama Qasim Agha | Internal Medicine | 350 W. Thomas Road, Suite 900a, Phoenix, AZ 85013 | 2013-08-29 |
| 1245679604 | Oculist Exceptional Eyewear Pllc | Optometrist | 5043-b N 7th Ave, Phoenix, AZ 85013 | 2013-06-19 |
| 1760829352 | Gina Wilding | Nurse Practitioner | 500 W Thomas Rd Ste 720, Phoenix, AZ 85013 | 2013-05-23 |
| Find all providers in zip 85013 | ||||
| Taxonomy Code | 2082S0099X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| Specialization | Plastic Surgery Within the Head and Neck |
| A plastic surgeon with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgery is practiced, there are many additional procedures which interface with them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. A subspecialty certificate was approved by the ABMS in 2000. ACGME Accredited Residency Program Requirements: None. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396905444 | Robert Simmonds Mindell | Plastic Surgery | 2762 E. Yale St., Phoenix, AZ 85008 | 2008-06-12 |
| 1063032266 | Rsat Professional Corporation | Plastic Surgery | 19841 N 27th Ave, Phoenix, AZ 85027-4003 | 2020-04-17 |
| 1013540889 | Elite Plastic Surgery and Restorative Breast Center | Plastic Surgery | 10910 N Tatum Blvd Ste B100, Phoenix, AZ 85028-3080 | 2020-02-19 |
| 1689748311 | Robert Ian Marouk | Plastic Surgery | 3900 E Camelback Rd, Suite 200, Phoenix, AZ 85018 | 2006-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831334820 | Jeffrey M. Nelson, M.d., P.C. | Plastic Surgery | 7416 N La Cholla Blvd, Tucson, AZ 85741-2306 | 2008-12-05 |
| 1942418132 | Maffi Plastic Surgery PC | Plastic Surgery | 5410 N Scottsdale Rd, Suite E-200, Paradise Valley, AZ 85253-5927 | 2007-05-19 |
| 1699749150 | Jeffrey Paul Edelstein | Plastic Surgery | 2905 W Warner Rd, Suite 20, Chandler, AZ 85224-1674 | 2006-02-13 |
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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.