Kelly Desimone (NPI# 1164572970, PAC ID# 9537434824) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPTOMETRY.
| Nation Provider ID (NPI) | 1164572970 |
| PAC ID by PECOS | 9537434824 |
| Professional Enrollment ID | I20171012002956 |
| Full Name | Kelly Desimone |
| Address |
15725 S 46th St Suite 112 Phoenix AZ 85048-0443 |
| Gender | F |
| Medical School | PENNSYLVANIA COLLEGE OF OPTOMETRY |
| Graduation Year | 1993 |
| Primary Specialty | OPTOMETRY |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 15725 S 46th St, Suite 112, Phoenix, AZ 85048-0443 |
| Street Address |
15725 S 46TH ST SUITE 112 |
| City | PHOENIX |
| State | AZ |
| Zip | 85048-0443 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Carrie C Goodrum | Nurse Practitioner | Take Care Health Arizona PC | 3960 E Chandler Blvd, Phoenix, AZ 85048-0300 |
| Vicky L Davis | Nurse Practitioner | Take Care Health Arizona PC | 3960 E Chandler Blvd, Phoenix, AZ 85048-0300 |
| Sarah Locke | Nurse Practitioner | Take Care Health Arizona PC | 3960 E Chandler Blvd, Phoenix, AZ 85048-0300 |
| Ansen D Blair | Physician Assistant | Take Care Health Arizona PC | 3960 E Chandler Blvd, Phoenix, AZ 85048-0300 |
| Carol D Moffett | Nurse Practitioner | Take Care Health Arizona PC | 3960 E Chandler Blvd, Phoenix, AZ 85048-0300 |
| Murray S Pratt | Optometry | Pratt Vision LLC | 3961 E Chandler Blvd, 106 Lifetime Eye Care, Phoenix, AZ 85048-0303 |
| Anthony Kash Sullenger | Optometry | Pratt Vision LLC | 3961 E Chandler Blvd, 106 Lifetime Eye Care, Phoenix, AZ 85048-0303 |
| Michael J De Rubeis | Optometry | 16515 S 40th St, Suite 111, Phoenix, AZ 85048-0559 | |
| Shari R Webster | Chiropractic | 16515 S 40th St, Suite 103, Phoenix, AZ 85048-0559 | |
| Daniel M Pacheco | Internal Medicine | 16515 S 40th St, Suite 119, Phoenix, AZ 85048-0559 | |
| Find all physicians in zip 85048 | |||
| City | PHOENIX |
| Zip Code | 85048 |
| Specialty | OPTOMETRY |
| City + Specialty | PHOENIX + OPTOMETRY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.