Michael T Burtis (NPI# 1396765335, PAC ID# 9830405281) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1396765335 |
| PAC ID by PECOS | 9830405281 |
| Professional Enrollment ID | I20150831000866 |
| Full Name | Michael T Burtis |
| Organization Legal Name | PHOENIX RADIOLOGY, PLLC |
| Address |
531 4th Ave Lewiston ID 83501-2450 |
| Phone Number | 2087434393 |
| Gender | M |
| Medical School | MEDICAL COLLEGE OF WISCONSIN |
| Graduation Year | 2004 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Secondary Specialties | INTERVENTIONAL RADIOLOGY |
| Group Practice PAC ID | 1254390354 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 130003 | ST JOSEPH REGIONAL MEDICAL CENTER |
| 131315 | SYRINGA GENERAL HOSPITAL |
| 131321 | ST MARYS HOSPITAL AND CLINICS |
| 501332 | TRI-STATE MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 531 4th Ave, Lewiston, ID 83501-2450 | 2087434393 | PHOENIX RADIOLOGY, PLLC |
| Organization Legal Name | PHOENIX RADIOLOGY, PLLC |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gregory R Spurling | Diagnostic Radiology | Phoenix Radiology, Pllc | 415 6th St, Lewiston, ID 83501-2431 |
| Paul J Sanchirico | Diagnostic Radiology | Phoenix Radiology, Pllc | 415 6th St, Lewiston, ID 83501-2431 |
| Dallen B Ashby | Diagnostic Radiology | Phoenix Radiology, Pllc | 531 4th Ave, Lewiston, ID 83501-2450 |
| Street Address |
531 4TH AVE |
| City | LEWISTON |
| State | ID |
| Zip | 83501-2450 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dallen B Ashby | Diagnostic Radiology | Phoenix Radiology, Pllc | 531 4th Ave, Lewiston, ID 83501-2450 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lori L Holder | Clinical Social Worker | 504 Main St, Suite 472, Lewiston, ID 83501-1806 | |
| Thomas R Boyer | Chiropractic | 717 D St, Lewiston, ID 83501-1826 | |
| Rebecca A Bohnenkamp | Clinical Social Worker | 523 /2 Main St, Suite 7, Lewiston, ID 83501-1870 | |
| Kristy Anne Kuehfuss | Psychologist, Clinical | 633 Main St, Suite B2, Lewiston, ID 83501-1882 | |
| Clinton R Morgan | Hematology/oncology | St Joseph Hospital LLC | 1250 Idaho St, Lewiston, ID 83501-1965 |
| Alice Myra Forsythe | Medical Oncology | St Joseph Hospital LLC | 1250 Idaho St, Lewiston, ID 83501-1965 |
| John Siebel | Hematology/oncology | St Joseph Hospital LLC | 1250 Idaho St, Lewiston, ID 83501-1965 |
| Michele R Dickison | Nurse Practitioner | St Joseph Hospital LLC | 1250 Idaho St, Lewiston, ID 83501-1965 |
| Debra L Street | Clinical Social Worker | 0309 2nd St, Lewiston, ID 83501-2163 | |
| Mark F Yama | Psychologist, Clinical | 428 6th Ave, Lewiston, ID 83501-2355 | |
| Find all physicians in zip 83501 | |||
| City | LEWISTON |
| Zip Code | 83501 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | LEWISTON + DIAGNOSTIC RADIOLOGY |
Please comment or provide details below to improve the information on Michael T Burtis.
| 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.