DISTRICT MEDICAL GROUP, INC (NPI# 1790018802) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790018802 |
| Entity Type | Organization |
| Organization Name | DISTRICT MEDICAL GROUP, INC |
| Practice Address |
2525 E Roosevelt St Pediatric Clinic Phoenix AZ 85008-4948 |
| Mailing Address |
2929 E Thomas Rd Phoenix AZ 85016-8034 |
| Practice Telephone | 6023441018 |
| Mailing Telephone | 6024705000 |
| Enumeration Date | 2009-09-09 |
| 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 | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2080P0201X |
Pediatrics Specialization: Pediatric Allergy/Immunology |
Allopathic & Osteopathic Physicians | ||
| N | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2080P0205X |
Pediatrics Specialization: Pediatric Endocrinology |
Allopathic & Osteopathic Physicians | ||
| N | 2080P0206X |
Pediatrics Specialization: Pediatric Gastroenterology |
Allopathic & Osteopathic Physicians | ||
| N | 2080P0207X |
Pediatrics Specialization: Pediatric Hematology-Oncology |
Allopathic & Osteopathic Physicians | ||
| N | 2080P0208X |
Pediatrics Specialization: Pediatric Infectious Diseases |
Allopathic & Osteopathic Physicians | ||
| N | 2080P0214X |
Pediatrics Specialization: Pediatric Pulmonology |
Allopathic & Osteopathic Physicians | ||
| N | 2080P0216X |
Pediatrics Specialization: Pediatric Rheumatology |
Allopathic & Osteopathic Physicians | ||
| Y | 208000000X | Pediatrics | 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 |
2525 E ROOSEVELT ST PEDIATRIC CLINIC |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85008-4948 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083698955 | Surabhi Amar | Internal Medicine | 2525 E Roosevelt St, Phoenix, AZ 85008-4948 | 2005-12-02 |
| 1982202982 | Katherine Brown | Dietitian, Registered | 2525 E Roosevelt St, Phoenix, AZ 85008-4948 | 2020-10-12 |
| 1295360287 | Stephanie Nicole Steeves | Dietitian, Registered | 2525 E Roosevelt St, Phoenix, AZ 85008-4948 | 2020-03-10 |
| 1154967602 | Danielle Fleck | Occupational Therapist | 2525 E Roosevelt St, Phoenix, AZ 85008-4948 | 2019-11-19 |
| 1336614858 | Teresa Dejesus Loera | Registered Nurse | 2525 E Roosevelt St, Phoenix, AZ 85008-4948 | 2018-10-11 |
| 1518445519 | Ari Blechner | Counselor | 2525 E Roosevelt St, Phoenix, AZ 85008-4948 | 2018-08-01 |
| 1194211755 | Adrienne Anne Jean Robb | Student in an Organized Health Care Education/Training Program | 2525 E Roosevelt St, Phoenix, AZ 85008-4948 | 2018-07-06 |
| 1629575246 | Andrea Jeanne Klock | Nurse Practitioner | 2525 E Roosevelt St, Phoenix, AZ 85008 | 2018-04-10 |
| 1003320904 | Sarah Taraborelli | Physician Assistant | 2525 E Roosevelt St, Phoenix, AZ 85008-4948 | 2017-11-30 |
| 1538680079 | Tessa Bowie | Physician Assistant | 2525 E Roosevelt St, Phoenix, AZ 85008-4948 | 2017-07-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902370349 | Dwayne St. Jacques Md Pllc | Pediatrics | 15215 South 48th Street, Suite 110, Phoenix, AZ 85044-9375 | 2019-01-18 |
| 1245703966 | Pleasant Pediatrics Plc | Pediatrics | 15715 S 46th St Ste 102, Phoenix, AZ 85048-0439 | 2019-01-04 |
| 1033642830 | Sumeet Gill | Pediatrics | 3805 E Bell Rd Ste 5100, Phoenix, AZ 85032-2174 | 2017-04-07 |
| 1639619968 | Pediatrics Kare LLC | Pediatrics | 7611 W Thomas Rd #co64, Phoenix, AZ 85033-5469 | 2017-03-06 |
| 1508300013 | Pediatrics & Family Kare Pllc | Pediatrics | 13229 N 41st Pl, Phoenix, AZ 85032-6709 | 2016-12-19 |
| 1881058931 | Nima Sekhadia | Pediatrics | 16611 S 40th St Ste 160, Phoenix, AZ 85048-0565 | 2016-04-05 |
| 1134580970 | Pleasant Pediatrics | Pediatrics | 2613 W Campbell Ave, Phoenix, AZ 85017-3770 | 2016-03-08 |
| 1174913826 | Arizona Pediatric Pllc | Pediatrics | 22 E Mitchell Dr, Phoenix, AZ 85012-2340 | 2015-02-03 |
| 1316282288 | Robert Fredrick Beauchamp | Pediatrics | 1 E Washington St, Suite 17, Phoenix, AZ 85004-2492 | 2012-12-04 |
| 1558634212 | Vishwabandhu J. Jhaveri | Pediatrics | 8220 N 23rd Ave, Building # 1, Phoenix, AZ 85021-4872 | 2012-02-10 |
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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.