DISTRICT MEDICAL GROUP, INC (NPI# 1528396108) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528396108 |
| Entity Type | Organization |
| Organization Name | DISTRICT MEDICAL GROUP, INC |
| Practice Address |
2601 E Roosevelt St Phoenix AZ 85008-4973 |
| Mailing Address |
2929 E Thomas Rd Phoenix AZ 85016-8034 |
| Practice Telephone | 6023445011 |
| Mailing Telephone | 6024705000 |
| Enumeration Date | 2009-11-19 |
| Last Update Date | 2014-10-01 |
| Authorized Official Name | TERESA CORDEIRO (CREDENTIALING DIRECTOR) |
| Authorized Official Telephone | 6024705000 |
| Is Organization Subpart | Y |
| Parent Organization Name | DISTRICT MEDICAL GROUP, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207LC0200X |
Anesthesiology Specialization: Critical Care Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207VC0200X |
Obstetrics & Gynecology Specialization: Critical Care Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2086S0102X |
Surgery Specialization: Surgical Critical Care |
Allopathic & Osteopathic Physicians | ||
| Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124667555 | District Medical Group, Inc | Family Medicine | 15182 N 75th Ave Ste 180, Peoria, AZ 85381-4722 | 2020-01-02 |
| 1366081705 | District Medical Group, Inc | Family Medicine | 3624 W Anthem Way Ste C116, Anthem, AZ 85086-0457 | 2020-01-02 |
| 1831722768 | District Medical Group, Inc | Surgery | 14155 N 83rd Ave Ste A105, Peoria, AZ 85381-5640 | 2020-02-19 |
| 1144860016 | District Medical Group, Inc | Internal Medicine | 6315 E Main St, Mesa, AZ 85205-8953 | 2020-01-08 |
| 1063052934 | District Medical Group, Inc | Family Medicine | 1805 N Scottsdale Rd, Tempe, AZ 85281-1556 | 2020-01-08 |
| 1538708979 | District Medical Group, Inc | Family Medicine | 10144 W Lake Pleasant Pkwy Ste 1110, Peoria, AZ 85382-9716 | 2020-01-02 |
| 1548653934 | District Medical Group, Inc | Emergency Medicine | 2601 E Roosevelt St, Toxicology, Phoenix, AZ 85008-4973 | 2015-03-10 |
| 1144624339 | District Medical Group, Inc | Emergency Medicine | 2601 E Roosevelt St, Emergency Medicine, Phoenix, AZ 85008-4973 | 2014-10-16 |
| 1407106719 | District Medical Group, Inc | Clinic/Center | 3141 N 3rd Ave, Phoenix, AZ 85013-4345 | 2012-09-13 |
| 1538484993 | District Medical Group, Inc | Internal Medicine | 2601 E Roosevelt St, Rheumatology, Phoenix, AZ 85008-4973 | 2010-03-29 |
| Street Address |
2601 E ROOSEVELT ST |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85008-4973 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538166152 | Paul Zidel I | Orthopaedic Surgery | 2601 E Roosevelt St, Dept of Surgery, Phoenix, AZ 85008-4973 | 2005-06-29 |
| 1881293165 | Christina Wellman | Registered Nurse | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2020-10-19 |
| 1639786544 | Lindsey Tow | Nurse Anesthetist, Certified Registered | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2020-09-24 |
| 1003424102 | Susannamma Lijan | Nurse Practitioner | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2020-07-15 |
| 1184241705 | Katharine Witham | Anesthesiology | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2020-06-30 |
| 1417574435 | Vishal Ravella | Student in an Organized Health Care Education/Training Program | 2601 E Roosevelt St, Valleywise Health, Phoenix, AZ 85008 | 2020-06-26 |
| 1841814894 | Anthony Howard Arnett | Nurse Anesthetist, Certified Registered | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2020-06-05 |
| 1053932277 | Bhavesh Shukla | Student in an Organized Health Care Education/Training Program | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2020-04-28 |
| 1659991016 | Luis Francisco Meza | Student in an Organized Health Care Education/Training Program | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2020-04-25 |
| 1396365839 | Nicholas Donahue Winter | Student in an Organized Health Care Education/Training Program | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2020-04-24 |
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|---|---|---|---|---|
| 1821607060 | Am Apnea and Tmj LLC | Durable Medical Equipment & Medical Supplies | 2303 N. 44thst., Suite 14-1008, Phoenix, AZ 85008 | 2020-07-23 |
| 1194341131 | Abdulbaril Olandapo Olagunju | Student in an Organized Health Care Education/Training Program | 2601 E Roosevelt Street, Valleywise Health, Phoenix, AZ 85008 | 2020-06-24 |
| 1376164632 | Abdul Rahman Raed Mustafa Halawa | Student in an Organized Health Care Education/Training Program | 2601 E Roosevelt St Valleywise Health, Phoenix, AZ 85008 | 2020-04-28 |
| 1245869460 | Zachary Masuda | Student in an Organized Health Care Education/Training Program | Valleywise Health Medical Center, 2601 E Roosevelt St, Phoenix, AZ 85008 | 2020-04-08 |
| 1942840145 | Cana Behavior LLC | Physical Therapist | 2412 N 36 Pl, Phoenix, AZ 85008 | 2020-01-15 |
| 1871158188 | Fred Gardezy | Student in an Organized Health Care Education/Training Program | Maricopa Integrated Health System 2601 E. Roosevelt St., Phoenix, AZ 85008 | 2019-05-02 |
| 1225692346 | Navkaran Singh Girgla | Student in an Organized Health Care Education/Training Program | 2601 East Roosevelt St., Phoenix, AZ 85008 | 2019-04-24 |
| 1316412323 | Southwest Human Developement | Early Intervention Provider Agency | 2850 N 24h Street, Phoenix, AZ 85008 | 2018-10-05 |
| 1558885970 | Mona Ridhwan Ziems | Midwife | 1919 N 31st St, Phoenix, AZ 85008 | 2017-07-27 |
| 1093244451 | Shana Cynamon | Audiologist | 1801 N 37th Pl, Phoenix, AZ 85008 | 2017-06-08 |
| Find all providers in zip 85008 | ||||
| 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 |
|---|---|---|---|---|
| 1326661851 | Intensivists of Arizona, LLC | Internal Medicine | 6970 E Chauncey Ln Ste 105, Phoenix, AZ 85054-5158 | 2020-05-19 |
| 1639517949 | Amr Ibrahim El Maghraby | Internal Medicine | 111 E Dunlap Ave Ste I-279, Phoenix, AZ 85020-2807 | 2013-06-08 |
| 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 |
| 1649434887 | Mahmoud Azmi Mahafzah | Internal Medicine | 5251 W Campbell Ave Ste 204, Phoenix, AZ 85031 | 2008-07-16 |
| 1629235833 | William Curtis Weese | Internal Medicine | 2525 E Montebello Ave, Phoenix, AZ 85016-2812 | 2008-05-16 |
| 1285846642 | Henry Luedy | Internal Medicine | 1112 E. Mcdowell Road, Phoenix, AZ 85006 | 2007-05-05 |
| 1104831890 | Jagruti A Patel | Internal Medicine | 9250 N 3rd St Ste 2035, Phoenix, AZ 85020-2437 | 2006-07-30 |
| 1053379263 | Da-wei Liao | Internal Medicine | 19841 N 27th Ave Ste 102, Phoenix, AZ 85027 | 2006-05-04 |
| 1326010471 | Manish J. Patel | Internal Medicine | 9212 N Central Ave, Phoenix, AZ 85020-2416 | 2006-02-03 |
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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.