MICHAEL A BUMANGLAG (NPI# 1245268820) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245268820 |
| Entity Type | Individual |
| Full Name | MICHAEL A BUMANGLAG |
| Credential | PA-C |
| Practice Address |
9165 W Thunderbird Rd Suite 200 Peoria AZ 85381-4847 |
| Mailing Address |
13640 N Plaza Del Rio Blvd Peoria AZ 85381-4846 |
| Practice Telephone | 6238763870 |
| Practice Fax Number | 6238150087 |
| Mailing Telephone | 6238763800 |
| Mailing Fax Number | 6238766965 |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2009-12-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
3446 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 164595 | 05 | |
| AZ | STATE LICENSE | 3446 | 01 |
| Street Address |
9165 W THUNDERBIRD RD SUITE 200 |
| City | PEORIA |
| State | AZ |
| Zip Code | 85381-4847 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508858754 | Kenneth B Caton | Physician Assistant | 9165 W Thunderbird Rd, Ste 100, Peoria, AZ 85381 | 2005-08-15 |
| 1750929949 | Banner Physician Specialists Arizona LLC | Clinic/Center | 9165 W Thunderbird Rd, Peoria, AZ 85381-4847 | 2019-12-18 |
| 1417503509 | Felicia Hendricks | Dietitian, Registered | 9165 W Thunderbird Rd, Peoria, AZ 85381-4847 | 2019-08-14 |
| 1841774478 | Valerie Taraborelli | Physician Assistant | 9165 W Thunderbird Rd, Peoria, AZ 85381-4847 | 2018-09-19 |
| 1245658707 | Rafael Antonio Buerba Siller | Orthopaedic Surgery | 9165 W Thunderbird Rd, Peoria, AZ 85381-4847 | 2014-04-02 |
| 1659795235 | Samantha Ann Karr | Pharmacist | 9165 W Thunderbird Rd, Suite 100, Peoria, AZ 85381-4847 | 2014-02-18 |
| 1588933139 | Banner Physician Specialists Arizona LLC | Durable Medical Equipment & Medical Supplies | 9165 W Thunderbird Rd, Peoria, AZ 85381-4847 | 2011-12-27 |
| 1013170232 | Tanay J Amin | Orthopaedic Surgery | 9165 W Thunderbird Rd, Suite 200, Peoria, AZ 85381-4847 | 2008-07-08 |
| 1720128051 | Chad R. Westphal | Podiatrist | 9165 W Thunderbird Rd, Ste 200, Peoria, AZ 85381-4847 | 2007-02-07 |
| 1265443782 | Rekha Kumari Agarwal | Internal Medicine | 9165 W Thunderbird Rd, Ste 200, Peoria, AZ 85381-4847 | 2006-08-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932712122 | Vicki L Grenier | Registered Nurse | 7558 W. Thunderbird Rd. Ste 1-507, Peoria, AZ 85381 | 2020-08-26 |
| 1568934107 | Earthwalk Wellness Group, LLC | Social Worker | 14050 North 83rd Avenue, Suite 290, Peoria, AZ 85381 | 2018-12-20 |
| 1316412059 | John & Biljana Feeley Dba J & B Assisted Living IIi Inc | Community Based Residential Treatment Facility, Mental Illness | 7331 W Sweetwater Avenue, Peoria, AZ 85381 | 2018-10-09 |
| 1467958611 | Arizona Community Pharmacy | Pharmacy | 14100 N 83rd Ave Ste 160, Peoria, AZ 85381 | 2018-04-04 |
| 1083112106 | Marissa Lynn Desjardins | Physical Therapist | 8240 W. Cactus Rd. Oakeson Physical Therapy, Peoria, AZ 85381 | 2018-01-23 |
| 1235651399 | Power Back Batteries LLC | Durable Medical Equipment & Medical Supplies | 9054 West Lisbon Ave, Peoria, AZ 85381 | 2017-07-11 |
| 1457897027 | Sonoran Sky Community Services | Community Based Residential Treatment Facility, Mental Illness | 7524 W. Alexandria Way, Peoria, AZ 85381 | 2017-01-06 |
| 1386023448 | Scott Boone | Registered Nurse | 7715 W Watson Ln, Peoria, AZ 85381 | 2015-05-22 |
| 1881084838 | Pinnacle Women's Center LLC | Obstetrics & Gynecology | 15396 N 83rd Ave Ste F100, Peoria, AZ 85381 | 2015-01-29 |
| 1245637081 | Kathi Locke | Counselor | 13460 N. 94th Drive, Suite J2, Peoria, AZ 85381 | 2014-11-21 |
| Find all providers in zip 85381 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669855193 | Sun Valley Surgical Physician Assistant, LLC | Physician Assistant | 9031 W Runion Dr, Peoria, AZ 85382-6472 | 2015-07-01 |
| 1487166690 | Erin M Carmean | Physician Assistant | 6000 N Allen Rd, Peoria, IL 61614-3294 | 2017-10-27 |
| 1427333087 | Colette K Hill | Physician Assistant | 1001 Main St Ste 300, Peoria, IL 61606-2036 | 2011-10-14 |
| 1184927709 | Mark D Lauffer | Physician Assistant | 6000 N Allen Rd, Peoria, IL 61614-3294 | 2010-12-21 |
| 1952476103 | Rebecca Barrick | Physician Assistant | 420 Ne Glen Oak Ave, Ste 301, Peoria, IL 61603-3105 | 2006-11-22 |
| 1891708491 | Gary Fisk | Physician Assistant | 5405 N Knoxville Ave, Peoria, IL 61614-5016 | 2006-08-14 |
| 1770507246 | Benjamin M Holman | Physician Assistant | 6000 N Allen Road, Peoria, IL 61614-3294 | 2006-07-27 |
| 1013972512 | Rob Wimmer | Physician Assistant | 7309 N Knoxville Ave, Peoria, IL 61614-2085 | 2006-04-18 |
| 1851380570 | Andrew S Reese | Physician Assistant | 6000 N Allen Road, Peoria, IL 61614-3294 | 2005-10-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760030647 | Blaine Wesley Price | Physician Assistant | 796 W Jardin Dr, Casa Grande, AZ 85122-6162 | 2019-09-03 |
| 1790347292 | James M Goldhardt | Physician Assistant | 1400 S Dobson Rd Ste A200, Mesa, AZ 85202-4707 | 2019-07-03 |
| 1972166858 | Red Heart Surgical Assisting | Physician Assistant | 43643 W Arizona Ave, Maricopa, AZ 85138-5642 | 2019-04-17 |
| 1053898833 | Sportsmedicine Outreach Specialist | Physician Assistant | 13247 N 80th Pl, Scottsdale, AZ 85260-4903 | 2018-07-24 |
| 1912496712 | Hw Surgical Assist, Pllc | Physician Assistant | 4057 E Laurel Ave, Gilbert, AZ 85234 | 2018-05-07 |
| 1346741501 | Coraesthetics Pllc | Physician Assistant | 2008 E Laguna Dr, Tempe, AZ 85282 | 2018-02-23 |
| 1366955155 | Jennifer R Osborne | Physician Assistant | 100 S Eastern Dawn Ave, Tucson, AZ 85748-1708 | 2017-11-15 |
| 1669985198 | Jacki Nichols | Physician Assistant | 5055 N Rock Canyon Rd, Tucson, AZ 85750-6003 | 2017-11-06 |
| 1720597214 | Merieme Khamsi | Physician Assistant | 14674 W Mountain View Blvrd #210, Surprise, AZ 85374 | 2017-09-27 |
| 1801305073 | Panduga Surgical Care, Pllc | Physician Assistant | 4904 S Power Rd Ste 103, Pmb 450, Mesa, AZ 85212-3610 | 2017-09-20 |
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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.