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Provider DirectoryDirectorio de proveedores
Arizona – Central (Gila and Pinal counties)
Central (condados de Gila y Pinal)
Directory of Physicians and Other Health Care Professionals
Directorio de médicos y proveedores de atención médica
For members enrolled in: / Para los miembros inscritos en:
AHCCCS Complete Care (Medicaid + CRS Fully Integrated + CRS Partially Integrated)
Member Services / Servicios para Miembros
1-800-348-4058, TTY 711
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We care about you and
your family's health.
UnitedHealthcare Community Plan partners with Arizona Health Care
Cost Containment System (AHCCCS), Arizona Department of Health
Services (ADHS) and Department of Economic Security (DES) to offer
many different health plans.
We've been here since 1982. You first knew us as Arizona Physicians IPA.
Now we're UnitedHealthcare Community Plan. Over the years, the names
of some of our plans have changed. But one thing never changes. That's
our promise to help you get access to the care you need.
UnitedHealthcare Commmunity Plan does not discriminate on the basis
of race, color, religion, sex, sexual orientation, age, disability, national
origin, veteran status, ancestry, health status or the need for, or cost of,
health services.
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Welcome to UnitedHealthcare Community Plan
Finding a Provider
This directory will help you find doctors and specialists in your area who participate with
UnitedHealthcare Community Plan. It also lists the names and addresses of hospitals, pharmacies
and dentists you should use, if you need those services.
You can also find a current list of network providers on our website at UHCCommunityPlan.com.
To choose or change your Primary Care Provider (PCP) call Member Services at the number below
and let us know. (Sometimes doctors may not accept new patients. If that's the case, we can help you
make another selection.)
Providers listed in this directory are current as of the date listed on the cover.
Information is subject to change.
Choosing a Primary Care Provider (PCP) for you and your family is easy
There are several types of PCPs listed in this directory.
Family General Practice: Adults and Children
Internal Medicine: Adults
Pediatrician: Children
Primary Care Providers
Member Services 1-800-348-4058, TTY 711
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Your health care is important to us. We carefully screen and pick our doctors so you receive the
best care. When you enroll, you will be assigned a Primary Care Physician (PCP). Your PCP is your
personal care doctor. Your PCP will provide or arrange the covered services you need. Make sure
you talk to your PCP about any health problems you have. That way, your PCP gets to know you
and your medical history. Always follow your PCP's instructions and get approval before you get
any medical services. If you are pregnant you may choose your Primary Care Obstetrician (PCO)
as your primary physician.
Changing Your PCP
Your PCP is an important part of your health care team. You and your PCP need to work together.
If for any reason you want to change your PCP, call Member Services. If you change your PCP, you
must choose another PCP from the UnitedHealthcare Community Plan Provider Directory. We can
help you choose a new PCP or tell you more about the PCPs in our network. If you are pregnant,
contact Healthy First Steps at 1-800-599-5985. Member Services can send you a list of our providers
at no cost to you. If your PCP does not speak your language, call Member Services. UnitedHealthcare
Community Plan will provide you with an interpreter at no cost to you.
Seeing a Specialist
Your PCP is in charge of ALL your covered health care needs. If you need specialty care, your PCP
may refer you to a specialist or another doctor. There are four exceptions to this:
• Members with special health care needs may directly access a specialist as appropriate
for the condition and identified needs. Preventive services are covered including well exams
and screenings.
• Women can make an appointment with an in-network Obstetrician/Gynecologist (OB/GYN) for
preventive or routine services without a referral from their PCP. (Please see the UnitedHealthcare
Community Plan Provider Directory for a list of doctors).
• All members can self-refer for behavioral health services. Your ID card has a phone number to
access behavioral health and substance abuse services.
• Members under 21 years of age can self-refer for dental and vision screenings.
Your Primary Care Physician (PCP)
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How to Use This Directory
This directory will help you find doctors and specialists in your area who participate with UnitedHealthcare Community Plan.
Check your member ID card to confirm the program/plan you are enrolled in. Your ID card is your
key to getting health care services. It has your ID number, your name, and other important information.
Your ID card identifies you as a UnitedHealthcare Community Plan member. Your ID card has a
phone number to access behavioral health and substance abuse services. Services are assigned
to a provider based on where you live. If you have questions or need help getting behavioral health
services, please call the number on your card.
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Sample Provider Listing
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Board Certification Board certification shows a physician's expert knowledge in a medical
specialty. Certification involves a process of testing and evaluation by specialists in the specific
area of medicine. A board-certified specialist participates in continuing education to learn about
the latest advances in medical science and technology in his/her specialty. You can check the
provider's board certifications on the American Board of Medical Specialists (ABMS) website.
Go to www.abms.org and click on “Is Your Doctor Certified?”
Languages other than English spoken
by the provider.
Limitations of the practice, such as
age restrictions or the inability to
accept new patients.
Wheelchair picture tells you the
provider is wheelchair-accessible.
All of the information in these provider listings is based upon the provider's application.
UnitedHealthcare checks this information when these providers join our network and every three
years (or sooner) when the provider is re-credentialed.
This chart will help you understand
each doctor's listing
Listing Example
Group Affiliation Family Practice
Medical Associates
Group Address 123 Main Street
Health Valley, AZ 54321
Provider Name John Smith, MD
Provider
Phone Number
555-555-5555
Provider Gender Male
1 Board Certification Family
Office Hours M 9 a.m. – 5 p.m.
T 9 a.m. – 5 p.m.
W 9 a.m. – 5 p.m.
Th 9 a.m. – 5 p.m.
F 9 a.m. – 5 p.m.
2 Languages Spanish
3 Limitations Min. age 18 years old
Existing patients only
4
Description of Provider Listings
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This chart will help you understand
each hospital's listing
Listing Example
Hospital Name GoodCare Hospital
Hospital Phone Number 222-123-4567
Hospital Address 627 South Wellness Street
Health Valley, AZ 54321
Accreditation Accredited By: The Joint
Commission (Accredited)
Sample Hospital Listing
Accreditation shows that the hospital has been evaluated by experts in hospital care. An accredited
hospital must participate in ongoing reviews to make sure that its operations are up to the latest
standards. Please see below for the possible rankings.
The Joint Commission is one entity that accredits hospitals. The following ratings are possible:
• Accredited: The hospital was in compliance with all standards when surveyed or within 90 days
of the survey.
• Preliminary Accreditation: The hospital passed a brief review of its compliance with the Joint
Commission's standards and will be surveyed more fully shortly.
• Conditional Accreditation: The hospital complies with some, but not all, of the Joint
Commission's standards, but will be surveyed more fully shortly.
• Provisional Accreditation: The hospital was not able to address all of the requirements for
improvement that the first survey suggested within 45 days, or the hospital failed to show that it
has been able to sustain compliance.
Accreditation can also be granted by the American Osteopathic Association (AOA), in which case the
listing will read, “Accreditation: AOA (Accredited).”
All of the information in these provider listings is based upon the provider's application.
UnitedHealthcare checks this information when these providers join our network and every three
years (or sooner) when the provider is re-credentialed.
Description of Hospital Listings
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Multispecialty Interdisciplinary Clinics (MSIC)
A Multispecialty Interdisciplinary Clinic (MSIC) may be chosen as your or your child's assigned health
home. At the MSIC, you and your family can meet face-to-face with your care team to get medical
care, behavioral health care services and be a part of your care plan development. Each MSIC is
open from 8 a.m. to 5 p.m. Monday through Friday.
MSICs are at the following locations:
DMG Children's Rehabilitative Services
3141 N 3rd Avenue
Phoenix, AZ 85013
602-914-1520
1-855-598-1871
www.dmgcrs.org
Children's Clinics
Square & Compass Building
2600 North Wyatt Drive
Tucson, AZ 85712
520-324-5437
1-800-231-8261, ext. 45437
www.childrensclinics.org
Children's Rehabilitative Services
1200 North Beaver
Flagstaff, AZ 86001
928-773-2054
1-800-232-1018
www.flagstaffmedicalcenter.com
Children's Rehabilitative Services
Tuscany Medical Plaza
2851 S Avenue B, Bld 25, #2504
Yuma, AZ 85364
928-336-2777
1-800-837-7309
www.yumaregional.org
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Behavioral Health Services
We are concerned about how you feel. Behavioral health services can help you with personal
problems that may affect you and/or your family. These problems may be stress, depression, anxiety
or using drugs or alcohol.
Your ID card has a phone number to access behavioral health and substance abuse services.
Services are assigned to a provider based on where you live. If you have questions or need help
getting behavioral health services, please call the number on your card.
What if I have a behavioral health crisis?
If you are experiencing a behavioral health crisis, it is important to get help right away. If you are
experiencing a behavioral health crisis, your ID card has a phone number to access behavioral health
and substance abuse services. If you have questions or need help getting behavioral health services,
please call the number on your card. All members are covered for behavioral health services in a crisis
or emergency situation.
Crisis Hotlines:
If you are experiencing a behavioral health crisis call one of the phone numbers below that matches
the county you live in.
Crisis Hotlines by County:
Phone:
Maricopa County . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-800-631-1314 or 602-222-9444
Cochise, Graham, Greenlee, La Paz, Pima, Pinal,
Santa Cruz and Yuma Counties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-866-495-6735
Apache, Coconino, Gila, Mohave, Navajo and Yavapai Counties . . . . . . . . . . . . 1-877-756-4090
Gila River and Ak-Chin Indian Communities . . . . . . . . . . . . . . . . . . . . . . . . . . .1-800-259-3449
Especially for Teens:
Teen Life Line phone or text . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 602-248-TEEN (8336)
National 24-Hour Crisis Hotlines:
Phone:
National Suicide Prevention Lifeline . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-800-273-TALK (8255)
National Substance Use and Disorder Issues
Referral and Treatment Hotline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-800-662-HELP (4357)
Text the word . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . “HOME” to 741741
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A nosotros nos importa la salud
de usted y de su familia.
UnitedHealthcare Community Plan en asociación con el Sistema de
Control de Precios de los Cuidados para la Salud de Arizona (Arizona
Health Care Cost Containment System – AHCCCS), con los Servicios
de Salud de Arizona (Arizona Department of Health Services – ADHS)
y con el Departamento de Seguridad Económica (Department of
Economic Security – DES) ofrece muchos diferentes planes de salud.
Nosotros hemos estado presentes desde el año de 1982. Usted
primero nos conoció como Arizona Physicians IPA. Ahora nosotros
somos UnitedHealthcare Community Plan. A través de los años, los
nombres de algunos de nuestros planes han cambiado. Pero hay una
cosa que nunca cambia y es nuestra promesa para usted que siempre
reciba nuestra ayuda para obtener el acceso a los cuidados de salud
que necesite.
UnitedHealthcare Community Plan no discrimina a la hora de prestar
servicios de salud, independientemente de raza, color, religión, sexo,
orientación sexual, edad, discapacidad, nacionalidad, condición de
veterano, ascendencia, estado de salud o la necesidad de o costo de
servicios de salud.
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Bienvenido a UnitedHealthcare Community Plan
Para encontrar a un proveedor
Este directorio le ayudará a encontrar los médicos y especialistas de su área que participan con
UnitedHealthcare Community Plan. También detalla los nombres y las direcciones de los hospitales,
farmacias y dentistas que debe consultar si necesita esos servicios.
Usted puede encontrar una lista actualizada de proveedores en nuestra red, consultando la Internet
en nuestra dirección: UHCCommunityPlan.com.
Para escoger por primera vez o para cambiar a su Proveedor de Atención Primaria (PCP), déjenos
saberlo llamando al Servicios para Miembros al número abajo anotado. (En algunas ocasiones
algunos doctores no aceptan nuevos pacientes. Si ese es el caso, nosotros podemos ayudarle a
hacer otra selección.)
El directorio de proveedores está actualizado hasta la fecha que figura en la tapa.
La información está sujeta a cambios.
Elegir un proveedor de atención primaria (PCP) para usted y su familia es fácil
Hay varios tipos de PCP incluidos en este directorio.
Medicina general familiar: Adultos y niños
Medicina interna: Adultos
Pediatras: Niños
Proveedores de atención primaria
Servicios para Miembros al 1-800-348-4058, TTY 711
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Su salud es importante para nosotros. Nosotros investigamos y seleccionamos a nuestros doctores
para que usted reciba los mejores cuidados de salud. Cuando usted se inscribe, se le asignará un
Doctor de Atención Primaria (PCP). Su PCP es su doctor personal para darle los cuidados de salud.
Su PCP le proveerá o hará los arreglos para proveerle de los cuidados con cobertura que usted
necesita. Asegúrese de hablar con su PCP acerca de cualquier problema de salud que usted tenga.
En esa forma, su PCP empezará a conocerle a usted y a su historia médica. Siga siempre las
instrucciones de su PCP y obtenga la aprobación para recibir servicios médicos antes de obtenerlos.
Si está embarazada, usted puede escoger al doctor Ginecólogo-obstetra de Atención Primaria (PCO)
que le atiende y designarlo como su doctor principal.
Para cambiar su PCP
Su PCP es una importante parte de su equipo para los cuidados de salud. Usted y su PCP deben
trabajar en conjunto. Si hay una razón por la cual quiere cambiar de PCP, llame a Servicios para
Miembros. Si usted cambia de PCP, debe escoger a otro PCP consultando el Directorio de
Proveedores de UnitedHealthcare Community Plan. Nosotros podemos ayudarle a escoger a un
nuevo PCP o podemos informarle con más detalles acerca de los PCP en nuestra red. Si usted está
embarazada, contacte a Healthy First Steps (Primeros Pasos de Salud) al 1-800-599-5985. Los
Servicios para Miembros le pueden enviar gratuitamente la lista de proveedores. Si su PCP no habla
su idioma, llame a Servicios para Miembros. UnitedHealthcare Community Plan le facilitará los
servicios de un intérprete sin ningún costo para usted.
Para consultar con un especialista
Su PCP está a cargo de TODAS las necesidades acerca de los servicios para los cuidados de su
salud. Si usted necesita de cuidados de salud especiales, su PCP puede referirle a un especialista
o a otro doctor. Existen cuatro excepciones para lo anterior:
• Miembros con necesidades de salud especiales pueden tener acceso directamente a un
especialista que sea él apropiado para la condición que usted padezca y que pueda identificar
cuáles son las necesidades existentes. Se cubren servicios preventivos que incluyen exámenes
del bienestar y pruebas de laboratorio.
• Miembros del sexo femenino pueden hacer una cita con un Ginecólogo-Obstetra (OB/GYN)
para recibir servicios preventivos o de rutina sin necesitar una referencia de su PCP. (Para
obtener una lista de doctores, por favor consulte el Directorio de Proveedores de
UnitedHealthcare Community Plan).
• Todos los miembros pueden autorreferirse para servicios de salud conductual. Su tarjeta de
identificación tiene un número de teléfono para acceder a servicios de salud conductual y
abuso de sustancias.
• Los miembros menores de 21 años pueden auto-referirse para obtener pruebas o exámenes
dentales o de la visión.
Su Doctor de Atención Primaria (PCP)
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Cómo usar este directorio
Este directorio lo ayudará a encontrar médicos y especialistas en su área que participen con UnitedHealthcare Community Plan.
Consulte su tarjeta de identificación de miembro para confirmar el programa/plan en el que está
inscrito. Su tarjeta de identificación es la clave para obtener servicios de atención médica. Tiene
su número de identificación, su nombre y otra información importante. Su tarjeta de identificación
lo identifica como miembro de UnitedHealthcare Community Plan. Su tarjeta de identificación tiene
un número de teléfono para acceder a servicios de salud conductual y abuso de sustancias. Los
servicios se asignan a un proveedor según su lugar de residencia. Si tiene alguna pregunta o
necesita ayuda para obtener servicios de salud conductual, llame al número que figura en su tarjeta.
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Ejemplo de una lista de proveedores
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Certificación de la junta médica: la certificación de la junta médica muestra el conocimiento
experto del médico en una especialidad médica. La certificación involucra un proceso de pruebas
y evaluaciones hechas por especialistas en un área médica específica. Un especialista certificado
por la junta médica participa continuamente en su educación para mantenerse al tanto de los
últimos avances de la ciencia médica y de la tecnología de su especialidad. Puede revisar las
certificaciones de la junta médica del proveedor en el sitio web de la Junta Americana de
Especialistas Médicos (American Board of Medical Specialists, ABMS). Visite www.abms.org
y haga clic en “Is Your Doctor Certified?” (“¿Está certificado su médico?”).
Idiomas que el proveedor puede
hablar además del inglés.
Las limitaciones de la práctica,
tales como restricciones de edad
o la imposibilidad de aceptar
nuevos pacientes.
La imagen de una silla de ruedas
le dice que ese proveedor tiene
accesos para silla de ruedas.
Toda la información que se encuentra en estas listas de proveedores depende de la solicitud de los
proveedores. UnitedHealthcare verifica esta información en el momento en que los proveedores se
unen a nuestra red y cada tres años (o menos) cuando el proveedor vuelve a ser acreditado.
Este cuadro le ayudará a comprender la lista
de cada médico
Listado Ejemplo
Afiliación del grupo Asociados médicos en
medicina familiar
Dirección del grupo 123 Main Street
Health Valley, AZ 54321
Nombre del proveedor John Smith, MD
Teléfono del proveedor 555-555-5555
Sexo del proveedor Masculino
1 Certificación de la
junta médica
Familia
Horarios de atención Lun. de 9 a.m. a 5 p.m.
Mar. de 9 a.m. a 5 p.m.
Mié. de 9 a.m. a 5 p.m.
Jue. de 9 a.m. a 5 p.m.
Vie. de 9 a.m. a 5 p.m.
2 Idiomas Español
3 Limitaciones Edad mínima de 18 años
Solo para pacientes existentes
4
Descripción de la lista de proveedores
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Este cuadro le ayudará a comprender la lista
de cada hospital
Listado Ejemplo
Nombre del hospital GoodCare Hospital
Número de teléfono
del hospital
222-123-4567
Dirección del hospital 627 South Wellness Street
Health Valley, AZ 54321
Acreditación Acreditado por: La Comisión
Conjunta (acreditada)
Ejemplo de lista de hospitales
La acreditación muestra que el hospital fue evaluado por expertos en atención hospitalaria. Un
hospital acreditado debe participar en los estudios continuos para asegurar que sus operaciones
cumplen con las normas más recientes. Revise las calificaciones posibles a continuación.
La Comisión Conjunta es una entidad que acredita a los hospitales. Las siguientes calificaciones
son posibles:
• Acreditado: El hospital estaba cumpliendo con todas las normas al momento de la revisión
o dentro de un lapso de 90 días de la misma.
• Acreditación preliminar: El hospital aprobó un breve estudio de su cumplimiento de acuerdo
con las normas de la Comisión Conjunta, y será revisado de manera más completa a la
brevedad.
• Acreditación condicional: El hospital cumple con algunas de las normas, pero no todas, de la
Comisión Conjunta, pero será revisado de manera más completa a la brevedad.
• Acreditación provisional: El hospital no pudo cumplir con todos los requisitos para mejorar
sugeridos en la primera revisión dentro de un lapso de 45 días, o el hospital no pudo demostrar
que fue capaz de mantener el cumplimiento.
La acreditación también puede ser otorgada por la Asociación Americana de Osteopatía (American
Osteopathic Association, AOA), en cuyo caso en el listado se leerá: “Acreditación: AOA (acreditado)”.
Toda la información que se encuentra en estas listas de proveedores depende de la solicitud de los
proveedores. UnitedHealthcare verifica esta información en el momento en que los proveedores se
unen a nuestra red y cada tres años (o menos) cuando el proveedor vuelve a ser acreditado.
Descripción de la lista de hospitales
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Clínicas Interdisciplinarias de Multi-Especialidad (Multispecialty Interdisciplinary Clinics – MSIC)
Una Clínica Interdisciplinaria de Multi-Especialidad (MSIC) puede ser elegida como su hogar de salud
asignado o el de su hijo(a). En la MSIC, usted y su familia pueden conocer personalmente al equipo
de cuidados médicos que le brindan sus cuidados de salud, los servicios para la salud conductual y
pueden también participar en el desarrollo de su plan de los cuidados para su salud. Todas las MSIC
están abiertos de las 8 a.m. a las 5 p.m. de lunes a viernes.
Las MSIC se localizan en las siguientes direcciones:
DMG Children's Rehabilitative Services
3141 N 3rd Avenue
Phoenix, AZ 85013
602-914-1520
1-855-598-1871
www.dmgcrs.org
Children's Clinics
Square & Compass Building
2600 North Wyatt Drive
Tucson, AZ 85712
520-324-5437
1-800-231-8261, ext. 45437
www.childrensclinics.org
Children's Rehabilitative Services
1200 North Beaver
Flagstaff, AZ 86001
928-773-2054
1-800-232-1018
www.flagstaffmedicalcenter.com
Children's Rehabilitative Services
Tuscany Medical Plaza
2851 S Avenue B, Bld 25, #2504
Yuma, AZ 85364
928-336-2777
1-800-837-7309
www.yumaregional.org
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Servicios para la Salud Conductual
A nosotros nos preocupa cómo se siente usted. Los servicios para la salud conductual pueden
ayudarle con los problemas personales que pueden afectarle a usted y/o a su familia. Estos
problemas pueden ser el estrés, la depresión, la ansiedad o por el uso de drogas o de alcohol.
Su tarjeta de identificación tiene un número de teléfono para contactar a los servicios de salud
conductual y los servicios para el abuso de substancias. Los servicios son asignados a un proveedor
de acuerdo al área en que usted vive. Si usted tiene cualquier pregunta o necesita ayuda para
obtener servicios para la salud conductual, por favor llame al número anotado en su tarjeta.
¿Qué pasa si yo tengo una crisis con la salud conductual?
Si usted está experimentando una crisis de salud conductual, es importante que busque ayuda de
inmediato. Si usted está experimentando una crisis de salud conductual, su tarjeta de identificación
tiene un número de teléfono para acceder a los servicios de salud conductual y abuso de sustancias.
Si tiene alguna pregunta o necesita ayuda para obtener servicios de salud conductual, llame al
número que figura en su tarjeta. Todos los miembros están cubiertos por servicios de salud
conductual en una situación de crisis o emergencia.
Líneas directas de crisis:
Si está experimentando una crisis de salud conductual, llame a uno de los números de teléfono que
figuran a continuación que coincida con el condado en el que vive.
Líneas directas de crisis por condado:
Teléfono:
Condado de Maricopa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-800-631-1314 o 602-222-9444
Condados de Cochise, Graham, Greenlee, La Paz,
Pima, Pinal, Santa Cruz y Yuma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-866-495-6735
Condados de Apache, Coconino, Gila, Mohave, Navajo y Yavapai . . . . . . . . . . . 1-877-756-4090
Comunidades Indígenas de Gila River y Ak-Chin . . . . . . . . . . . . . . . . . . . . . . . .1-800-259-3449
Especialmente para adolescentes:
Teléfono o texto de Teen Life Line . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 602-248-TEEN (8336)
Líneas directas nacionales de crisis las 24 horas:
Teléfono:
Línea de alerta nacional para la prevención del suicidio . . . . . . . . . . . . . 1-800-273-TALK (8255)
Temas nacionales de uso y desorden de sustancias
Línea de referencia y tratamiento . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-800-662-HELP (4357)
Envíe un texto . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . “HOME” al 741741
UHCCommunityPlan.com
CSAZ.18.999.01.9.017
UnitedHealthcare Community Plan does not treat members differently because of sex, age, race,
color, disability or national origin.
If you think you were treated unfairly because of your sex, age, race, color, disability or national origin,
you can send a complaint to:
Civil Rights Coordinator
UnitedHealthcare Civil Rights Grievance
P.O. Box 30608
Salt Lake City, UTAH 84130
You must send the complaint within 60 calendar days of when you found out about it. A decision
will be sent to you within 30 calendar days. If you disagree with the decision, you have 15 calendar
days to ask us to look at it again.
If you need help with your complaint, please call Member Services at 1-800-293-3740, TTY 711,
Monday through Friday, 8:00 a.m. to 5:00 p.m.
You can also file a complaint with the U.S. Dept. of Health and Human Services.
Online:
https://ocrportal.hhs.gov/ocr/portal/lobby.jsf
Complaint forms are available at
http://www.hhs.gov/ocr/office/file/index.html
Phone:
Toll-free 1-800-368-1019, 1-800-537-7697 (TDD)
Mail:
U.S. Dept. of Health and Human Services
200 Independence Avenue SW
Room 509F, HHH Building
Washington, D.C. 20201
If you need help with your complaint, please call Member Services at 1-800-293-3740, TTY 711.
Services to help you communicate with us are provided at no cost
to members, such as other languages or large print. Or, you can ask
for an interpreter. To ask for help, please call Member Services at
1-800-293-3740, TTY 711, Monday through Friday, 8:00 a.m. to
5:00 p.m.
CSAZ15MC4033073_002
CSAZ.18.999.01.9.017
UnitedHealthcare Community Plan no da un tratamiento diferente a sus miembros en base a
su sexo, edad, raza, color, discapacidad u origen nacional.
Si usted piensa que ha sido tratado injustamente por razones como su sexo, edad, raza, color,
discapacidad u origen nacional, puede enviar una queja a:
Civil Rights Coordinator
UnitedHealthcare Civil Rights Grievance
P.O. Box 30608
Salt Lake City, UTAH 84130
Usted tiene que enviar la queja dentro de los 60 días de la fecha cuando se enteró de ella. Se le
enviará la decisión en un plazo de 30 días. Si no está de acuerdo con la decisión, tiene 15 días
para solicitar que la consideremos de nuevo.
Si usted necesita ayuda con su queja, por favor llame al 1-800-293-3740, TTY 711, de lunes a viernes,
de 8:00 a.m. a 5:00 p.m.
Usted también puede presentar una queja con el Departamento de Salud y Servicios Humanos
de los Estados Unidos.
Internet:
https://ocrportal.hhs.gov/ocr/portal/lobby.jsf
Formas para las quejas se encuentran disponibles en:
http://www.hhs.gov/ocr/office/file/index.html
Teléfono:
Llamada gratuita, 1-800-368-1019, 1-800-537-7697 (TDD)
Correo:
U.S. Department of Health and Human Services
200 Independence Avenue SW
Room 509F, HHH Building
Washington, D.C. 20201
Si necesita ayuda para presentar su queja, por favor llame a Servicios para Miembros al
1-800-293-3740, TTY 711.
Se proporcionan servicios para ayudarle a comunicarse con
nosotros, tales como otros idiomas o letra grande, sin costo para los
miembros. O bien, puede solicitar un intérprete. Para pedir ayuda,
por favor llame a Servicios para Miembros del 1-800-293-3740,
TTY 711, de lunes a viernes, de 8:00 a.m. a 5:00 p.m.
CSAZ.18.999.01.9.017
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CSAZ.18.999.01.9.017
National Vendors / Proveedores Nacionales..........................................................................................22
Multispecialty Interdisciplinary Clinic / Multi Especialidad Clinica Interdisciplinaria ..................29
Hospitals / Hospitales...............................................................................................................................31
Primary Care Providers / Proveedores De Cuidado Primario............................................................32
Specialists / Especialistas.........................................................................................................................52
Dental Providers / Proveedores De Servicios Dentales.......................................................................116
Nationwide Vision Providers / Proveedores De Nationwide Vision ..................................................117
Pharmacy / Farmacia ............................................................................................................................118
Ancillary Providers / Proveedores Auxiliares .....................................................................................120
Federally Qualified Health Care Agency/Rural Health Clinic / Agencia De Atención Médica Con
Certificación Federal/Clínica De Salud Rural ....................................................................................125
Primary Care Obstetricians / Obstetras De Atención Primaria .......................................................126
Behavioral Health Providers / Proveedores De Salud Mental...........................................................129
Behavioral Health Facilities / Servicios De Salud Mental..................................................................138
Index / Índice ..........................................................................................................................................140
Table Of Contents / Tabla de Contenido
IMPORTANT:
Providers listed in this directory are current as of January 8, 2020.
Information is subject to change.
Please contact Member Services at 1-800-348-4058 or (TTY/TDD 711).
CSAZ.18.999.01.9.017
National Vendors The following national vendors are available to provide services to
UnitedHealthcare customers throughout the United States regardless of where you receive the
services.
Provider(s) Phone Number Website
Cardiac Diagnostic - Cardiac Monitoring Services
Preventice Services 1-888-747-1442 www.preventicesolutions.com/services/pr
eventice-services.html
Cardiac Diagnostic - Cardiac Monitoring Services & Home INR Monitor/test strips
CardioNet 1-888-312-2328 www.cardionet.com
Convenience Care Clinic
MinuteClinic 1-866-389-ASAP (2727) www.minuteclinic.com
The Little Clinic 1-877-852-2677 http://www.thelittleclinic.com
Walgreens Healthcare Clinic 1-866-825-3227 www.walgreens.com/topic/pharmacy/heal
thcare-clinic
Dialysis
Amercian Renal Associates
Inc. (ARA)
1-877-997-3625 www.americanrenal.com
DaVita Dialysis 1-866-475-7757 ext.
253706
www.davita.com
Dialysis Clinic, Inc See website www.dciinc.org
Fresenius Medical Care 1-866-434-2597 www.fmcna.com
DME - AED - wearable defibrillator
ZOLL Lifecore 1-800-543-3267 www.zoll.com
DME - Ambulatory Infusion Pumps
InfuSystem Inc 1-800-962-9656 www.infusystem.com
DME - Bone Growth Stimulator
Bioventus 1-800-396-4325 www.bioventusglobal.com
DJO 1-800-321-9549 www.djortho.com
EBI 1-800-526-2579 www.biomet.com
Orthofix 1-800-535-4492 www.orthofix.com
DME - Breast pump purchase
McKesson/Target Breast
Pump Program
1-855-406-7867 www.mckesson.com/providers/home-
care/mckesson-patient-care-solutions
Medline Industries 1-800-633-5463 www.medline.com
22
CSAZ.18.999.01.9.017
Provider(s) Phone Number Website
DME - CPM/Continuous Passive Motion
Otto Bock Healthcare 1-800-328-4058 www.ottobockus.com
DME - CPM/continuous passive motion, Thermocomp, TENS
Kinex Medical Company 1-800-845-6364 www.kinexmedical.com
DME - Diabetic insulin pump and pump supplies
Insulet Corporation 1-800-591-3455 www.myomnipod.com
MiniMed Distribution 1-877-576-6113 www.minimed.com
DME - Dynamic Splinting; Bracing & Orthotics
Dynasplint Systems 1-800-638-6771 www.dynasplint.com
DME - Home INR Monitor/test strips
Roche Diagnostics Corp 1-800-779-7616 www.coaguchek.com/coaguchek_patient/
en/home/products/how_to_get_a_coaguc
hek.html
DME - Incontinence, diapers, soft goods and wound care supplies
Medline Industries 1-800-633-5463 www.medline.com
DME - Mobility products - custom/complex power wheelchairs and seating systems
Numotion 1-888-232-1333 www.numotion.com
DME - Mobility products custom/complex power wheelchairs and seating systems
National Seating & Mobility See website www.nsm-seating.com/findus
DME - Negative pressure wound pump and wound care surfaces
KCI USA 1-800-275-4524 www.kci1.com
DME - Orthotics and Prosthetics
Linkia Orthotics & Prosthetics 1-877-754-6542 www.linkia.com
DME - Pnuematic Compression Devices
Tactile Technology Systems 1-866-435-3948 www.tactilemedical.com
DME - POV and Power wheelchairs
Hoveround Corporation 1-888-225-1547 www.hoveround.com/MobilityNow
DME - Respiratory high frequency chest compression oscillation system (vest)
Advanced Respiratory 1-800-826-4224 www.thevest.com
Electromed 1-800-462-1045 www.smartvest.com
RespirTech 1-800-793-1261 www.respirtech.com
DME - Speech generating device
23
CSAZ.18.999.01.9.017
Provider(s) Phone Number Website
Prentke Romich 1-800-268-5224 www.prentrom.com
Tobii Dynavox Systems 1-866-396-2869 www.dynavoxtech.com/tobii-dynavox
DME - Standard DME (beds, walkers, wheelchairs) cpap, enteral, home PT/INR, negative
pressure wound care, oxygen, respiratory
Lincare - may be known
locally by a different name;
refer to website
See website www.lincare.com
DME - Standard DME (beds, walkers, wheelchairs) cpap, enteral, negative pressure wound
care, oxygen, respiratory
Apria Healthcare 1-800-277-4288 www.apria.com
DME - Standard DME (beds, walkers, wheelchairs) cpap, enteral, oxygen, respiratory
Rotech Healthcare - may be
known locally by a different
name; refer to website
See website www.rotech.com
DME - TENS units
Electrostim Medical Services,
Inc
1-800-588-8383 www.wecontrolpain.com
Zynex Medical 1-800-495-6670 www.zynexmed.com
DME - Wound care supplies for residents of nursing homes
Gordian Medical, Inc 1-800-568-5514 www.amtwoundcare.com
Hearing Aid Services - Hearing aid services / hearing testing, evaluation, hearing aid selection
and fitting
UnitedHealthcare Hearing 1-855-523-9355 TTY
711
www.uhchearing.com
Home Health
Heartland Healthcare
Services
1-800-736-4427 / 1-
419-252-5500
www.hcr-manorcare.com or
www.heartlandhomehealth.com
Innovative Senior Care See website www.brookdaleliving.com/Innovative-
senior-care.aspx
Maxim Health Care Services 1-800-899-9525 www.maximhomecare.com
Home Infusion - TPN, Enteral and Synagis
BioScrip Infusion Services 1-866-788-7710 www.bioscrip.com
Hospice - Home and inpatient
Heartland Healthcare
Services
1-800-736-4427 / 1-
419-252-5500
www.hcr-manorcare.com or
www.heartlandhomehealth.com
Laboratory - Anatomic pathology - including dermatopathology
24
CSAZ.18.999.01.9.017
Provider(s) Phone Number Website
Bako Integrated Physician
Solutions
1-877-376-7284 www.bakocts.com
Laboratory - Anatomic pathology - including dermatopathology, gastroenterology,
genitourinary, hematology and gynecological pathology
AmeriPath 1-800-354-3449 www.ameripath.com
StrataDx Pathology 1-800-325-7284 www.stratadx.com
Laboratory - BRCA for breast & ovarian cancer; COLARIS for colon & endometrial cancer;
MELARIS for melanoma & pancreatic cancer; Theraguide 5-FU
Myriad Genetic Laboratories 1-800-469-7423 www.myriad.com
Laboratory - Clinical
Tribal Diagnostics 1-405-896-2978 www.tribaldiagnostics.com
Laboratory - Clinical, pathology and genetic testing
ARUP Labs 1-800-522-2787 www.aruplab.com
Laboratory Corporation of
America
1-888-522-2677 (1-888-
LABCORP)
www.labcorp.com
Lineagen, Inc 1-801-931-6200 www.lineagen.com
Mayo Clinic Laboratories 1-800-533-1710 www.mayomedicallaboratories.com
Quest Diagnostics
Incorporated
See website www.questdiagnostics.com
Laboratory - Dialysis testing
Nationwide Laboratory
Services
1-888-377-3522 www.nationwidelab.com
Laboratory - Fecal DNA screening
Exact Sciences Laboratories 1-844-870-8870 www.cologuardtest.com
Laboratory - Genetic testing
Ambry Genetics 1-866-262-7943 www.ambrygen.com
GeneDx 1-301-519-2100 www.genedx.com
Natera, Inc 1-650-249-9090 www.natera.com
Laboratory - Genetic testing (OncotypeDx)
Genomic Health 1-888-662-6897 (1-888-
ONCOTYPE)
www.genomichealth.com
Laboratory - Molecular Diagnostics
Veracyte 1-888-9AFIRMA www.veracyte.com
Laboratory - Molecular Oncology
25
CSAZ.18.999.01.9.017
Provider(s) Phone Number Website
NeoGenomics Laboratories,
Inc
1-866-776-5907 neogenomics.com
Laboratory - Nerve Pathology (ENFD)
Therapath Neuropathology 1-800-681-4338 www.therapath.com
Laboratory - Oncometrix, hematopathology, gastrointestinal pathology, dermatopathology,
gynecologic pathology
Poplar Healthcare 1-888-244-7284 www.poplarhealthcare.com
Laboratory - Prenatal testing
Eurofins NTD, LLC 1-888-762-4000 www.perkinelmer.com
Laboratory - Specialty genetic testing
Invitae Corporation 1-800-436-3037 www.invitae.com
Laboratory - Therapeutic medication monitoring, drug testing
Aegis Sciences Corporation 1-800-533-7052 www.aegislabs.com
Dominion Diagnostics 1-800-511-8427 / 1-
800-711-6974
www.dominiondiagnostics.com
Millennium Health 1-877-451-3534 www.milleniumlaboratories.com
Precision Diagnostics 1-800-635-6901 www.precisiondxlab.com
Rennova Health 1-844-RENNOVA www.rennovahealth.com
Other Specialty Services - Urgent care services
Concentra Health Services See website www.concentra.com
Other Specialty Services - Women’s health - high risk OB / prenatal care
Optum Women's and
Children's Health
1-800-950-3963 www.alere.com
Specialty Pharmacy
AllianceRx Walgreens Prime 1-888-282-5166 www.walgreenshealth.com
BriovaRx Specialty Pharmacy 1-866-218-7398 www.briovarx.com
Orsini Pharmaceutical
Services
1-800-672-0869 www.orsinihealthcare.com
Specialty Pharmacy - Carticel, Elelyso and Prolastin
Dohmen Life Science
Services
1-866-336-1336 www.dohmen.com
Specialty Pharmacy - Limited Distribution Specialty Drugs
Biologics 1-800-856-1984 www.biologicsinc.com
Caremark 1-877-287-1234 www.cvsspecialty.com
26
CSAZ.18.999.01.9.017
Provider(s) Phone Number Website
Specialty Pharmacy - Triptodur
PantheRx Specialty Pharmacy 1-855-726-8479 www.pantherspecialty.com
Specialty Pharmacy and Home Infusion - Limited Distribution Drugs
BriovaRx Infusion Services 1-877-306-4036 www.briovarxinfusion.com
Option Care 1-866-827-8203 www.optioncare.com
Specialty Pharmacy and Home Infusion - Limited Distribution Drugs - Zolgensma, Luxturna
Accredo 1-800-803-2523 www.accredo.com
Transportation - Fixed-Wing Air Ambulance
AirCARE1 International 1-877-760-7760 www.airambulanceone.com
Castle International See website www.castlemedflight.com
Medway Air Ambulance 1-800-233-0655 www.medwayairambulance.com
Vaccine Program - Influenza, Pneumonia, Shingles, Tdap, Meningitis, Hepatitis A/B, HPV,
MMR, MMRV, Varicella, TDAP (age 15 and up) Available at Retail Pharmacy or Worksite Clinic
CVS Pharmacy (d/b/a CVS
Pharmacy, Long’s Drug,
CarePlus Pharmacy)
1-888-358-7468 www.cvs.com/promo/promoLandingTemp
late.jsp?promoLandingId=get-vaccinated
Harris Teeter See website www.harristeeter.com/in_our_stores/depar
tments/pharmacy/flu_shots/details.aspx
Kmart Pharmacy 1-800-349-0764 www.pharmacy.kmart.com
Safeway, Inc. (d/b/a Safeway,
Carrs, Pak'N Save, Pavilions,
Randalls, Tom Thumb, Vons)
1-877-723-3929 www.safeway.com/shopstores/pharmacy
The Kroger Co See website www.kroger.com/topic/pharmacy/#/vacci
nations-made-easy
United Supermarkets (d/b/a
United Supermarket,
Albertsons Market, Amigos,
Market Street)
1-877-276-9637 www.unitedsupermarkets.com
Walmart Stores Inc. (d/b/a
Walmart and Sam’s Club)
See website www.walmart.com
Vaccine Program - Influenza, Pneumonia, Shingles,Tdap, Meningitis,Hepatitis B, HPV, TDAP
(age 15 and up) Worksite Clinics and Retail locations
Walgreens Immunization
(d/b/a Walgreens, Duane
Reade)
1-800-925-4733 https://www.walgreens.com/pharmacy/im
munization
27
CSAZ.18.999.01.9.017
DME - DURABLE MEDICAL EQUIPMENT is certain medical equipment that is ordered by your
doctor for use at home. DME includes but is not limited to: wheelchairs, crutches, hospital bed, IV
infusion pump, oxygen equipment, nebulizer, and walker.
HOME HEALTH/HOME INFUSION CARE can either be a licensed facility or medical personnel that
can provide health care services in the home. Services include but are not limited to nursing visits
for infusion services or wound care.
LABORATORY means diagnostic testing including routine blood and urine analysis, anatomic
pathology, surgical pathology, and specialty or esoteric services.
SPECIALTY PHARMACY PROVIDER provides specific drug products directly to customers or
physicians.
WOMEN'S HEALTH is limited to home uterine monitoring services.
28
CSAZ.18.999.01.9.017
Multispecialty Interdisciplinary Clinics (MSIC)
A Multispecialty Interdisciplinary Clinic (MSIC) may be chosen as your or your child’s assigned health
home. At the MSIC, you and your family can meet face-to-face with your care team to get medical
care, behavioral health care services and be a part of your care plan development. Each MSIC is
open from 8:00 a.m. to 5:00 p.m. Monday through Friday.
MSICs are at the following locations:
DMG Children’s Rehabilitative Services
3141 N 3rd Avenue
Phoenix, AZ 85013
602-914-1520
1-855-598-1871
www.dmgcrs.org
Children’s Clinics
Square & Compass Building
2600 North Wyatt Drive
Tucson, AZ 85712
520-324-5437
1-800-231-8261, ext. 45437
www.childrensclinics.org
Children’s Rehabilitative Services
1200 North Beaver
Flagstaff, AZ 86001
928-773-2054
1-800-232-1018
www.flagstaffmedicalcenter.com
Children’s Rehabilitative Services
Tuscany Medical Plaza
2851 S Avenue B, Bld 25, #2504
Yuma, AZ 85364
928-336-2777
1-800-837-7309
www.yumaregional.org
UHCCommunityPlan.com
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CSAZ.18.999.01.9.017
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CSAZ.18.999.01.9.017
Arizona
Gila
Acute Care Hospital / Atención
Hospitalaria Aguda
These hospitals offer Emergency
Services & Post Stabilization
Services
Banner Payson Medical Center
Provider ID 000284725002
NPI: 1063893121
807 S Ponderosa St
Payson, AZ 85541
(928) 471-3222 EB, P, R
Web address: http://www.bannerhea
lth.com
Cobre Valley Regional Medical
Center
Provider ID 000220201001
NPI: 1548591720
124 N Tewksbury Blvd
Young, AZ 85554
(928) 462-3435 EB, P, R
Cobre Valley Regional Medical
Center
Provider ID 000220201001
NPI: 1548591720
186 E Stephens Way
Tonto Basin, AZ 85553
(928) 479-2871 EB, P, R
Cobre Valley Regional Medical
Center
Provider ID 000220201001
NPI: 1548591720
5880 S Hospital Dr
Globe, AZ 85501
(928) 425-3261 EB, P, R
Web address: http://www.cvrmc.org
Cobre Valley Regional Medical
Center
Provider ID 000220201001
NPI: 1548591720
5886 S Hospital Dr
Globe, AZ 85501
(928) 402-1131 EB, P, R
Cobre Valley Regional Medical
Center
Provider ID 000220201001
NPI: 1548591720
5994 S Hospital Dr
Globe, AZ 85501
(928) 425-7108 EB, P, R
California
Riverside
Acute Care Hospital / Atención
Hospitalaria Aguda
These hospitals offer Emergency
Services & Post Stabilization
Services
Palo Verde Hospital
Provider ID 000685746001
NPI: 1194705202
250 N First St
Blythe, CA 92225
(760) 922-4115
Utah
Kane
Acute Care Hospital / Atención
Hospitalaria Aguda
These hospitals offer Emergency
Services & Post Stabilization
Services
Kane County Hospital
Provider ID 000421169001
NPI: 1740519370
355 N Main
Kanab, UT 84741
(435) 644-5811 EB, P, R
Web address: kchosp.net
Washington
Acute Care Hospital / Atención
Hospitalaria Aguda
These hospitals offer Emergency
Services & Post Stabilization
Services
Dixie Regional Medical Center
Provider ID 000453998001
NPI: 1366452880
1380 E Medical Ctr Dr
Saint George, UT 84790
(435) 251-1000 EB, P, R
Web address: intermountainhealthca
re.org
Hospitals / Hospitales Utah - Washington
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services
31
CSAZ.18.999.01.9.017
Arizona
Gila
Family Nurse Practitioner /
Enfermera De Familia
Alten, Kimberly B, FNP, (F)
Western Vascular Institute
Provider ID 003471547007
NPI: 1326175704
708 S Coeur D Alene Ln Ste B
Payson, AZ 85541
(480) 668-5000 EB, P, R
Languages Spoken:
Staff: Spanish
Ages: 0-99
Hospital Affiliations:
Banner Payson Medical Center
Gwinn, Karen S, FNP, (F)
Integrated Medical Services
Provider ID 007028610002
NPI: 1558832154
111 W Cedar Ln
Payson, AZ 85541
(928) 472-4675 EB, P, R
Ages: 0-99
Maxwell, Krissie, NP, (M)
North Country Healthcare
Provider ID 006932335007
NPI: 1750856621
126 E Main St Ste B
Payson, AZ 85541
(928) 468-8610 EB, P, R
Ages: 0-99
Nichols, Deborah, FNP, (F)
Dan Nurse Practitioner Services
Provider ID 002695560008
NPI: 1962425389
200 W Frontier St Ste M
Payson, AZ 85541
(928) 478-6280 EB, P, R
Ages: 18-99
Rector, Tamara H, FNP, (F)
Banner Primary Care Physicians
Arizona
Provider ID 005185782006
NPI: 1225443815
117 E Main St Ste A100
Payson, AZ 85541
(928) 596-4500 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Payson Medical Center
Rector, Tamara H, FNP, (F)
Banner Primary Care Physicians
Arizona
Provider ID 005185782004
NPI: 1225443815
6152 Hardscrabble Rd
Pine, AZ 85544
(928) 596-4848 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Payson Medical Center
Stanley, Lisa A, NP, (F)
North Country Healthcare
Provider ID 005329393003
NPI: 1003213422
708 Coeur D'alene Ste B
Payson, AZ 85541
(928) 468-8610 E, EB, IB, P, R
Ages: 0-99
Hospital Affiliations:
Western Arizona Regional
Medical
Vigil, Lynne A, FNP, (F)
Alan Patrick Michels
Provider ID 001998225006
NPI: 1912967704
806 S Ponderosa St
Payson, AZ 85541
(928) 468-8603 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Payson Medical Center
Areas of Expertise: Developmental
Disabilities
Family Practice / Medicina
Familiar
Andrade, Oscar E, MD, (M), B
Medcom Medical
Provider ID 001898514001
NPI: 1275685521
108 S Broad St
Globe, AZ 85501
(928) 425-6592 E, EB, IB, P, R
Languages Spoken:
Provider: Spanish
Staff: Spanish
Mo-Th - 7:00 AM - 5:00 PM
Fr - 8:00 AM - 5:00 PM
Ages: 0-99
Hospital Affiliations:
Cobre Valley Regional Medical
Center
Areas of Expertise: Developmental
Disabilities
Campbell, Douglas J, MD, (M), B
Cobre Valley Tonto Basin Clinic
Provider ID 001778189006
NPI: 1720071384
186 E Stephens Way
Tonto Basin, AZ 85553
(928) 479-2871 EB, P, R
Languages Spoken:
Provider: Croatian, German,
Arizona - Gila Primary Care Providers / Proveedores De Cuidado Primario
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
32
CSAZ.18.999.01.9.017
Romanian, Russian, Serbian
Ages: 0-99
Hospital Affiliations:
Cobre Valley Regional Medical
Center
Yavapai Regional Medical Center
West
Campbell, Douglas J, MD, (M), B
Cobre Valley Tonto Basin Clinic
Provider ID 001778189003
NPI: 1720071384
5994 S Hospital Dr
Globe, AZ 85501
(928) 425-7108 EB, P, R
Languages Spoken:
Provider: Croatian, German,
Romanian, Russian, Serbian
Ages: 0-99
Hospital Affiliations:
Cobre Valley Regional Medical
Center
Yavapai Regional Medical Center
West
Cooper, Randal, MD, (M), B
North Country Healthcare
Provider ID 007208787008
NPI: 1235581539
126 E Main St Ste B
Payson, AZ 85541
(928) 468-8610
Ages: 0-99
Druschel, Michael J, MD, (M), B
North Country Healthcare
Provider ID 006771716009
NPI: 1750794731
126 E Main St Ste B
Payson, AZ 85541
(928) 468-8610
Ages: 0-99
Hospital Affiliations:
Kittitas Valley Community Hosp
Fader, Paul F, MD, (M), B
North Country Healthcare
Provider ID 000882554004
NPI: 1942205620
708 Coeur D'alene Ste B
Payson, AZ 85541
(928) 468-8610 E, EB, IB, P, R
Ages: 0-99
Hospital Affiliations:
Flagstaff Medical Center
Goodman, Brian W, DO, (M)
North Country Healthcare
Provider ID 006356398012
NPI: 1497165732
126 E Main St Ste B
Payson, AZ 85541
(928) 472-3700 EB, P, R
Ages: 0-99
Holsten, Raymond L, MD, (M), B
Canyonlands Community Health
Care Vista
Provider ID 001701339003
NPI: 1003810540
5860 S Hospital Dr Ste 102
Globe, AZ 85501
(928) 402-0491 E, EB, G, IB, P,
PL, R, T
Languages Spoken:
Staff: Spanish
Interpreter: Medical Interp
Vendor
Mo-Fr - 7:00 AM - 6:00 PM
Cultural Competency: Y
Ages: 0-99
Hospital Affiliations:
Banner Page Hospital
Areas of Expertise: Developmental
Disabilities
Jensen, David L, DO, (M), B
Community Care Partners
Provider ID 003192251014
NPI: 1174855159
1100 N Beeline Hwy Ste A
Payson, AZ 85541
(480) 462-2950 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Mountain West Medical Center
Scttsdle Hlth Osb
Keen, Brent L, MD, (M)
Banner Primary Care Physicians
Arizona
Provider ID 006883785001
NPI: 1023404092
117 E Main St Ste A100
Payson, AZ 85541
(928) 596-4500 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Payson Medical Center
Knecht, Richard D, MD, (M)
North Country Healthcare
Provider ID 001096613002
NPI: 1598814261
708 Coeur D'alene Ste B
Payson, AZ 85541
(928) 468-8610 E, EB, IB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Montrose Memorial Hospital
Moab Regional Hospital
Primary Care Providers / Proveedores De Cuidado Primario Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
33
CSAZ.18.999.01.9.017
Mugo, Patti W, MD, (F), B
North Country Healthcare
Provider ID 005694414002
NPI: 1013272988
708 Coeur D'alene Ste B
Payson, AZ 85541
(928) 468-8610 E, EB, IB, P, R
Languages Spoken:
Staff: Spanish
Ages: 0-99
Patalinghug, Neal P, MD, (M), B
North Country Healthcare
Provider ID 001382916009
NPI: 1588697544
126 E Main St Ste B
Payson, AZ 85541
(928) 468-8610 EB, P, R
Ages: 0-99
Hospital Affiliations:
Meritus Medical Center
Washington County Hospital
Rooney, Holly E, MD, (F), B
Rooney Holly E
Provider ID 002029245004
NPI: 1194738674
1100 E Monroe St Ste 101
Globe, AZ 85501
(928) 425-3557 E, EB, IB, P, R, T
Cultural Competency: Y
Ages: 0-99
Hospital Affiliations:
Cobre Valley Regional Medical
Center
Rooney, Holly E, MD, (F), B
Hope Family Care Ctr
Provider ID 002029245008
NPI: 1194738674
285 N Broad St
Globe, AZ 85501
(928) 425-8200 EB, P, R
Cultural Competency: Y
Ages: 0-99
Hospital Affiliations:
Cobre Valley Regional Medical
Center
Smith, Gary A, MD, (M), B
Cobre Valley Physician Services
Provider ID 001991124008
NPI: 1538126487
5880 S Hospital Dr
Globe, AZ 85501
(928) 425-3261 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Thompson, Joseph C, DO, (M)
Banner Primary Care Physicians
Arizona
Provider ID 007184861001
NPI: 1821541723
117 E Main St Ste A100
Payson, AZ 85541
(928) 596-4500 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Payson Medical Center
Truong, Frank, MD, (M), B
Banner Hospital Ba Phys Az
Provider ID 003710769005
NPI: 1649572546
807 S Ponderosa St
Payson, AZ 85541
(928) 474-3222 EB, P, R
Languages Spoken:
Provider: German
Ages: 0-99
Hospital Affiliations:
Casa Grande Regional Med Ctr
Banner Casa Grande Medical
Center
Banner Payson Medical Center
Banner Gateway Medical Center
Wade, Laura, MD, (F)
North Country Healthcare
Provider ID 007185410008
NPI: 1801243902
126 E Main St Ste B
Payson, AZ 85541
(928) 468-8610 EB, P, R
Ages: 0-99
Yoder, Paul T, MD, (M)
North Country Healthcare
Provider ID 001769024048
NPI: 1780779991
708 S Coeur D Alene Ln Ste B
Payson, AZ 85541
(928) 468-8610 EB, P, R
Ages: 0-99
Hospital Affiliations:
Yavapai Regional Medical Center
West
Banner Payson Medical Center
Memorial Hospital Of South Bend
Federally Qualified Health Care
Agency / Agencia De Salud
Federalmente Calificados
Canyonlands Hlthcr-Globe
Provider ID 005380500001
NPI: 1417218876
5860 S Hospital Dr Ste 102
Globe, AZ 85501
(928) 402-0491 E, EB, G, IB, P,
PL, R, T
Does Not Accept New Patients
Ages: 0-99
North Country Hlth-Payson
Provider ID 005354251001
NPI: 1093146755
708 Coeur D'alene Ste B
Payson, AZ 85541
(928) 468-8610 E, EB, IB, P, R
Does Not Accept New Patients
Ages: 0-99
Arizona - Gila Primary Care Providers / Proveedores De Cuidado Primario
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
34
CSAZ.18.999.01.9.017
Internal Medicine / Medicina
Interna
Abbott, Brandon H, DO, (M), B
North Country Healthcare
Provider ID 005455599001
NPI: 1528350139
708 S Coeur D Alene Ln Ste B
Payson, AZ 85541
(928) 522-9410 EB, P, R
Ages: 0-99
Hospital Affiliations:
Flagstaff Medical Center
Chandra-Shekharan, Binoy, MD,
(M), B
Cobre Valley Regional Medical
Center
Provider ID 001933779001
NPI: 1811931595
5880 S Hospital Dr
Globe, AZ 85501
(928) 425-3261 EB, P, R
Languages Spoken:
Provider: Hindi
Staff: Spanish
Ages: 0-99
Hospital Affiliations:
Cobre Valley Regional Medical
Center
Islam, Shahedul, MD, (M), B
Cobre Valley Physician Services
Provider ID 002544817006
NPI: 1275530446
124 N Tewksbury Blvd
Young, AZ 85554
(928) 462-3435 EB, P, R
Languages Spoken:
Provider: Bengali, Chinese,
Spanish
Cultural Competency: Y
Ages: 0-99
Hospital Affiliations:
Cobre Valley Regional Medical
Center
Hca Houston Healthcare West
Mhhs Southwest Hospital
Islam, Shahedul, MD, (M), B
Cobre Valley Physician Services
Provider ID 002544817004
NPI: 1275530446
288 Tewksbury Rd
Young, AZ 85554
(928) 462-3435 EB, P, R
Languages Spoken:
Provider: Bengali, Chinese,
Spanish
Cultural Competency: Y
Ages: 0-99
Hospital Affiliations:
Cobre Valley Regional Medical
Center
Hca Houston Healthcare West
Mhhs Southwest Hospital
Islam, Shahedul, MD, (M), B
Cobre Valley Physician Services
Provider ID 002544817003
NPI: 1275530446
5860 S Hospital Dr Ste 102
Globe, AZ 85501
(928) 425-3247 E, EB, G, IB, P,
PL, R, T
Languages Spoken:
Provider: Bengali, Chinese,
Spanish
Cultural Competency: Y
Ages: 0-99
Hospital Affiliations:
Cobre Valley Regional Medical
Center
Hca Houston Healthcare West
Mhhs Southwest Hospital
Islam, Shahedul, MD, (M), B
Cobre Valley Physician Services
Provider ID 002544817002
NPI: 1275530446
5880 S Hospital Dr
Globe, AZ 85501
(928) 425-3261 EB, P, R
Languages Spoken:
Provider: Bengali, Chinese,
Spanish
Cultural Competency: Y
Ages: 0-99
Hospital Affiliations:
Cobre Valley Regional Medical
Center
Hca Houston Healthcare West
Mhhs Southwest Hospital
Martin, Cynthia E, MD, (F), B
North Country Healthcare
Provider ID 002400013016
NPI: 1346290962
708 S Coeur D Alene Ln Ste B
Payson, AZ 85541
(928) 522-9410 EB, P, R
Ages: 0-18
Hospital Affiliations:
Flagstaff Medical Center
Melde, Richard A, MD, (M)
Medcom Medical
Provider ID 001783879045
NPI: 1710027438
108 S Broad St
Globe, AZ 85501
(928) 402-0952 E, EB, IB, P, R
Ages: 0-99
Hospital Affiliations:
Wickenburg Community Hospital
Jcl Dv Hospital
Primary Care Providers / Proveedores De Cuidado Primario Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
35
CSAZ.18.999.01.9.017
Michels, Alan P, MD, (M)
Ponderosa Family Care
Provider ID 002110980001
NPI: 1376512129
806 S Ponderosa St
Payson, AZ 85541
(928) 468-8603 EB, P, R
Mo-Th - 8:00 AM - 5:30 PM
Fr - 8:00 AM - 12:00 PM
Ages: 0-99
Hospital Affiliations:
North Fl Regional Medical Center
Banner Payson Medical Center
Newland, Anne M, MD, (F), B
North Country Healthcare
Provider ID 002411822003
NPI: 1336178912
708 S Coeur D Alene Ln Ste B
Payson, AZ 85541
(928) 468-8610 EB, P, R
Ages: 0-99
Hospital Affiliations:
Flagstaff Medical Center
Raja, Rubina A, MD, (F), B
North Country Healthcare
Provider ID 003161436046
NPI: 1811124530
708 Coeur D'alene Ste B
Payson, AZ 85541
(928) 468-8610 E, EB, IB, P, R
Languages Spoken:
Provider: Hindi, Urdu
Ages: 0-99
Hospital Affiliations:
Mountain Vista Medical Ctr
Nurse Practitioner / Enfermera
Especialista
Bartholomew, Patricia A, NP, (F)
North Country Healthcare
Provider ID 006678025002
NPI: 1033463807
708 Coeur D'alene Ste B
Payson, AZ 85541
(928) 468-8610 E, EB, IB, P, R
Ages: 18-99
Bishop, Karen, NP, (F)
North Country Healthcare
Provider ID 006875462001
NPI: 1407286156
708 Coeur D'alene Ste B
Payson, AZ 85541
(928) 468-8610 E, EB, IB, P, R
Ages: 18-99
Boon, Roberta E, NP, (F)
Canyonlands Community Health
Care Vista
Provider ID 005843854010
NPI: 1942684253
111 W Blake St Ste 12
Globe, AZ 85501
(928) 425-8158 EB, P, R
Ages: 0-99
Boon, Roberta E, NP, (F)
Canyonlands Community Health
Care Vista
Provider ID 005843854004
NPI: 1942684253
5860 S Hospital Dr Ste 102
Globe, AZ 85501
(928) 402-0491 E, EB, G, IB, P,
PL, R, T
Ages: 0-99
Burdick, Jeremy K, NP, (M)
North Country Healthcare
Provider ID 003653607002
NPI: 1518309350
708 Coeur D'alene Ste B
Payson, AZ 85541
(928) 468-8610 E, EB, IB, P, R
Ages: 18-99
Callahan, Kimberly A, NP, (F)
North Country Healthcare
Provider ID 003440299016
NPI: 1457515835
708 S Coeur D Alene Ln Ste B
Payson, AZ 85541
(928) 522-9410 EB, P, R
Ages: 18-99
Carlile, Maranda S, NP, (F)
Canyonlands Community Health
Care Vista
Provider ID 006463914004
NPI: 1376078196
5860 S Hospital Dr Ste 102
Globe, AZ 85501
(928) 402-0491 E, EB, G, IB, P,
PL, R, T
Ages: 18-99
Areas of Expertise: Developmental
Disabilities
Celani, Lacey B, NP, (F)
Canyonlands Community Health
Care Vista
Provider ID 006071289004
NPI: 1972951119
5860 S Hospital Dr Ste 102
Globe, AZ 85501
(928) 402-0491 E, EB, G, IB, P,
PL, R, T
Ages: 18-99
Arizona - Gila Primary Care Providers / Proveedores De Cuidado Primario
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
36
CSAZ.18.999.01.9.017
Crane, Heather A, NP, (F)
Canyonlands Community Health
Care Vista
Provider ID 003529635027
NPI: 1194074443
5860 S Hospital Dr Ste 102
Globe, AZ 85501
(928) 402-0491 E, EB, G, IB, P,
PL, R, T
Languages Spoken:
Provider: American Sign
Language, Spanish
Ages: 18-99
Hospital Affiliations:
Valleywise Health
Areas of Expertise: Developmental
Disabilities
Draper, Joann, NP, (F)
Canyonlands Community Health
Care Vista
Provider ID 002883181006
NPI: 1710161310
5860 S Hospital Dr Ste 102
Globe, AZ 85501
(928) 402-0491 E, EB, G, IB, P,
PL, R, T
Ages: 18-99
Areas of Expertise: Developmental
Disabilities
Falke, Sharon L, NP, (F)
North Country Healthcare
Provider ID 002071104005
NPI: 1578591947
708 Coeur D'alene Ste B
Payson, AZ 85541
(928) 468-8610 E, EB, IB, P, R
Ages: 18-99
Hospital Affiliations:
Tucson Medical Center
Carondelet St Marys Hospital
Northwest Medical Center
St Josephs Hsp And Med Ctr
Freeman, Monica, NP, (F)
North Country Healthcare
Provider ID 006263597003
NPI: 1093266470
708 Coeur D'alene Ste B
Payson, AZ 85541
(928) 468-8610 E, EB, IB, P, R
Ages: 18-99
Hospital Affiliations:
Cox Medical Center
Green, Christie A, NP, (F)
Community Bridges
Provider ID 006702307002
NPI: 1982153649
803 W Main St
Payson, AZ 85541
(928) 468-0022 EB, P, R
Ages: 0-99
Areas of Expertise: Provider Led
Integrated Care Coordination
Jarrell, Christopher, NP, (M)
North Country Healthcare
Provider ID 006545604012
NPI: 1700309697
708 S Coeur D Alene Ln Ste B
Payson, AZ 85541
(928) 468-8610 EB, P, R
Ages: 18-99
Judd, Lois M, NP, (F)
Hospitalists Of Arizona
Provider ID 002974822004
NPI: 1841218138
1100 E Monroe St
Globe, AZ 85501
(800) 353-2708 EB, IB, P, PL, R
Ages: 0-99
Judd, Lois M, NP, (F)
Dan Nurse Practitioner Services
Provider ID 002974822008
NPI: 1841218138
200 W Frontier St Ste M
Payson, AZ 85541
(928) 478-6280 EB, P, R
Ages: 18-99
Kigundu, Jacqueline, NP, (F)
Canyonlands Community Health
Care Vista
Provider ID 006335440004
NPI: 1750833539
5860 S Hospital Dr Ste 102
Globe, AZ 85501
(928) 402-0491 E, EB, G, IB, P,
PL, R, T
Languages Spoken:
Provider: Swahili
Ages: 18-99
Areas of Expertise: Developmental
Disabilities
Lassen, Judith M, NP, (F)
North Country Healthcare
Provider ID 003231815022
NPI: 1831407865
708 S Coeur D Alene Ln Ste B
Payson, AZ 85541
(928) 522-9410 EB, P, R
Ages: 18-99
Hospital Affiliations:
Kingman Regional Medical Center
Lietzow, Rebecca J, NP, (F)
North Country Healthcare
Provider ID 005746668008
NPI: 1538450630
126 E Main St Ste B
Payson, AZ 85541
(928) 468-8610 EB, P, R
Ages: 18-99
Hospital Affiliations:
St Croix Regional Medical Center
Primary Care Providers / Proveedores De Cuidado Primario Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
37
CSAZ.18.999.01.9.017
Mcguffin, Martha R, NP, (F)
North Country Healthcare
Provider ID 006876558001
NPI: 1407226269
708 Coeur D'alene Ste B
Payson, AZ 85541
(928) 468-8610 E, EB, IB, P, R
Ages: 18-99
Mcweeney, Colleen, NP, (F)
North Country Healthcare
Provider ID 006647057001
NPI: 1366957177
708 Coeur D'alene Ste B
Payson, AZ 85541
(928) 468-8610 E, EB, IB, P, R
Ages: 18-99
Miller, Elizabeth G, NP, (F)
North Country Healthcare
Provider ID 006362824001
NPI: 1154860765
708 Coeur D'alene Ste B
Payson, AZ 85541
(928) 468-8610 E, EB, IB, P, R
Ages: 18-99
Hospital Affiliations:
St Johns Medical Center
Morse, Suzanne, NP, (F)
Northern Arizona Pain Svcs
Provider ID 002748654002
NPI: 1386750511
708 S Coeur D Alene Ln Ste C
Payson, AZ 85541
(928) 474-2234 EB, P, R
Mo-Th - 8:00 AM - 5:00 PM
Fr - 8:00 AM - 12:00 PM
Ages: 0-99
Nelson, Gloriajean, NP, (F)
Gloriajean Nelson
Provider ID 005384866002
NPI: 1043601040
1100 E Monroe St Ste 523
Globe, AZ 85501
(928) 302-2220 EB, P, R
Ages: 18-99
Nichols, Deborah, FNP, (F)
Dan Nurse Practitioner Services
Provider ID 002695560008
NPI: 1962425389
200 W Frontier St Ste M
Payson, AZ 85541
(928) 478-6280 EB, P, R
Ages: 18-99
Pierce, Donald L, NP, (M)
Community Care Partners
Provider ID 005243423005
NPI: 1013912294
1100 N Beeline Hwy Ste A
Payson, AZ 85541
(480) 462-2950 EB, P, R
Ages: 18-99
Ramat, Shanna, NP, (F)
North Country Healthcare
Provider ID 006858533009
NPI: 1669902508
126 E Main St Ste B
Payson, AZ 85541
(928) 468-8610 EB, P, R
Ages: 18-99
Salvatore, Theresa S, NP, (F)
North Country Healthcare
Provider ID 006194929014
NPI: 1144682584
708 S Coeur D Alene Ln Ste B
Payson, AZ 85541
(928) 468-8610 EB, P, R
Ages: 18-99
Savage, Colleen M, NP, (F)
North Country Healthcare
Provider ID 005145610013
NPI: 1790103711
708 S Coeur D Alene Ln Ste B
Payson, AZ 85541
(928) 468-8610 EB, P, R
Ages: 18-99
Scales, Krystal, NP, (F)
Hope Family Care Ctr
Provider ID 006669462002
NPI: 1518404177
285 N Broad St
Globe, AZ 85501
(928) 425-8200 EB, P, R
Ages: 0-99
Shackelford, Laura, NP, (F)
North Country Healthcare
Provider ID 006893085013
NPI: 1821005968
708 S Coeur D Alene Ln Ste B
Payson, AZ 85541
(928) 522-9410 EB, P, R
Ages: 18-99
Shanah, Sara, NP, (F)
North Country Healthcare
Provider ID 007218589007
NPI: 1891341020
126 E Main St Ste B
Payson, AZ 85541
(928) 468-8610 EB, P, R
Ages: 0-99
Silveira, Gina, NP, (F)
North Country Healthcare
Provider ID 006500641016
NPI: 1407302300
126 E Main St Ste B
Payson, AZ 85541
(928) 472-3700 EB, P, R
Ages: 18-99
Arizona - Gila Primary Care Providers / Proveedores De Cuidado Primario
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
38
CSAZ.18.999.01.9.017
Silveira, Gina, NP, (F)
North Country Healthcare
Provider ID 006500641017
NPI: 1407302300
708 S Coeur D Alene Ln Ste B
Payson, AZ 85541
(928) 472-3700 EB, P, R
Ages: 18-99
Stoit, Sarah, NP, (F)
North Country Healthcare
Provider ID 006061919002
NPI: 1093175440
708 Coeur D Alene
Payson, AZ 85541
(928) 468-8610 EB, P, R
Ages: 18-99
Turney-Shaw, Jean R, NP, (F)
Canyonlands Community Health
Care
Provider ID 002391128004
NPI: 1871545905
5860 S Hospital Dr Ste 102
Globe, AZ 85501
(928) 402-0491 E, EB, G, IB, P,
PL, R, T
Languages Spoken:
Provider: Spanish
Mo,We,Th,Fr - 7:00 AM - 6:00 PM
Tu - 6:00 AM - 6:00 PM
Ages: 0-99
Hospital Affiliations:
Cobre Valley Regional Medical
Center
Veltkamp, Claire, FNP, (F)
North Country Healthcare
Provider ID 005758105033
NPI: 1649641135
126 E Main St Ste B
Payson, AZ 85541
(928) 468-8610 EB, P, R
Ages: 18-99
Hospital Affiliations:
Valleywise Health
Veltkamp, Claire, FNP, (F)
North Country Healthcare
Provider ID 005758105038
NPI: 1649641135
708 S Coeur D Alene Ln Ste B
Payson, AZ 85541
(928) 522-9410 EB, P, R
Ages: 18-99
Hospital Affiliations:
Valleywise Health
Watkins, Katherine, NP, (F)
North Country Healthcare
Provider ID 006631663011
NPI: 1255480422
708 S Coeur D Alene Ln Ste B
Payson, AZ 85541
(928) 468-8610 EB, P, R
Ages: 18-99
Watson, Fanae F, NP, (F), B
North Country Healthcare
Provider ID 006319441002
NPI: 1417315318
708 Coeur D'alene Ste B
Payson, AZ 85541
(928) 468-8610 E, EB, IB, P, R
Ages: 18-99
Williamson, Pamela, NP, (F)
Barnet Dulaney Perkins Eye Ctr
Provider ID 006559532003
NPI: 1932457553
411 S Beeline Hwy Ste A
Payson, AZ 85541
(928) 474-3556 EB, P, R
Ages: 0-99
Zmrzel, Sara, NP, (F)
North Country Healthcare
Provider ID 007087479008
NPI: 1871158022
126 E Main St Ste B
Payson, AZ 85541
(928) 468-8610 EB, P, R
Ages: 18-99
Pediatrics / Pediatría
Alvarez-Corona, April C, MD, (F)
North Country Healthcare
Provider ID 003085772023
NPI: 1699926048
708 S Coeur D Alene Ln Ste B
Payson, AZ 85541
(928) 468-8610 EB, P, R
Ages: 0-18
Hospital Affiliations:
Flagstaff Medical Center
Austin, Glen D, DO, (M), B
North Country Healthcare
Provider ID 002585538006
NPI: 1528155082
708 Coeur D'alene Ste B
Payson, AZ 85541
(928) 468-8610 E, EB, IB, P, R
Ages: 0-18
Hospital Affiliations:
Flagstaff Medical Center
Primary Care Providers / Proveedores De Cuidado Primario Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
39
CSAZ.18.999.01.9.017
Garcia, Matilda C, MD, (F), B
North Country Healthcare
Provider ID 002122853007
NPI: 1295775443
708 S Coeur D Alene Ln Ste B
Payson, AZ 85541
(928) 468-8610 EB, P, R
Languages Spoken:
Provider: Tagalog
Ages: 0-18
Hospital Affiliations:
Banner Payson Medical Center
Banner Desert Medical Center
St Josephs Hsp And Med Ctr
Chandler Regional Medical Center
Hunt, Judith A, MD, (F), B
Ponderosa Family Care
Provider ID 001417174007
NPI: 1023087459
806 S Ponderosa St
Payson, AZ 85541
(928) 468-8603 EB, P, R
Ages: 0-18
Hospital Affiliations:
Banner Payson Medical Center
Banner Univ Medical Cntr
Phoenix Campus
Phx Childrens Hospital
Jain, Neal, MD, (M), B
San Tan Allergy & Asthma
Provider ID 002437343004
NPI: 1356390512
708 S Coeur D Alene Ln Ste C
Payson, AZ 85541
(480) 626-6600 EB, P, R
Languages Spoken:
Provider: Spanish
Cultural Competency: Y
Ages: 0-18
Hospital Affiliations:
St Marys Hosp Med Ctr Madison
Ssm Health St Marys Hospital
Madison
Valleywise Health
Banner Desert Medical Center
Jimenez, Angela C, MD, (F), B
Cobre Valley Physician Services
Provider ID 003526920002
NPI: 1619268463
124 N Tewksbury Blvd
Young, AZ 85554
(928) 462-3435 EB, P, R
Languages Spoken:
Provider: Spanish
Mo-Fr - 9:00 AM - 4:30 PM
Ages: 0-18
Hospital Affiliations:
Arroyo Grande Community
Hospital
Marian Regional Medical Center
Banner Desert Medical Center
Jimenez, Angela C, MD, (F), B
Cobre Valley Physician Services
Provider ID 003526920004
NPI: 1619268463
5886 S Hospital Dr
Globe, AZ 85501
(928) 402-1131 EB, P, R
Languages Spoken:
Provider: Spanish
Staff: Spanish
Ages: 0-18
Hospital Affiliations:
Arroyo Grande Community
Hospital
Marian Regional Medical Center
Banner Desert Medical Center
Martin, Cynthia E, MD, (F), B
North Country Healthcare
Provider ID 002400013016
NPI: 1346290962
708 S Coeur D Alene Ln Ste B
Payson, AZ 85541
(928) 522-9410 EB, P, R
Ages: 0-18
Hospital Affiliations:
Flagstaff Medical Center
Song, Miran J, MD, (F), B
North Country Healthcare
Provider ID 003449096012
NPI: 1366415846
708 S Coeur D Alene Ln Ste B
Payson, AZ 85541
(928) 522-9410 EB, P, R
Ages: 0-18
Witt, Norina, MD, (F), B
North Country Healthcare
Provider ID 006565472012
NPI: 1538505235
708 S Coeur D Alene Ln Ste B
Payson, AZ 85541
(928) 468-8610 EB, P, R
Ages: 0-18
Physician Assistant / Asistente
Médico
Anderson, Phan T, PA, (F)
Canyonlands Community Health
Care Vista
Provider ID 005778595004
NPI: 1265570105
5860 S Hospital Dr Ste 102
Globe, AZ 85501
(928) 402-0491 E, EB, G, IB, P,
PL, R, T
Ages: 0-99
Arizona - Gila Primary Care Providers / Proveedores De Cuidado Primario
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
40
CSAZ.18.999.01.9.017
Beenfield, Scott, PA, (M)
Canyonlands Community Health
Care Vista
Provider ID 006547557004
NPI: 1740707181
5860 S Hospital Dr Ste 102
Globe, AZ 85501
(928) 402-0491 E, EB, G, IB, P,
PL, R, T
Ages: 0-99
Brown, Mark S, PA, (M)
Canyonlands Community Health
Care Vista
Provider ID 006010849005
NPI: 1346601929
5860 S Hospital Dr Ste 102
Globe, AZ 85501
(928) 402-0491 E, EB, G, IB, P,
PL, R, T
Accepting Existing Patients Only
Ages: 0-99
Campbell, Chad, PA, (M)
Hope Family Care Ctr
Provider ID 002419114005
NPI: 1982763470
285 N Broad St
Globe, AZ 85501
(928) 425-8200 EB, P, R
Ages: 0-99
Cooper, Heather A, PA, (F)
Cobre Valley Regional Medical
Center
Provider ID 003796987001
NPI: 1740614262
124 N Tewksbury Blvd
Young, AZ 85554
(928) 462-3435 EB, P, R
Ages: 0-99
Demack, Michael K, PA, (M)
Ponderosa Family Care
Provider ID 003497193001
NPI: 1043347313
806 S Ponderosa St
Payson, AZ 85541
(928) 468-8603 EB, P, R
Ages: 0-99
Areas of Expertise: Developmental
Disabilities
Foulger, Jordan, PA, (M)
Cobre Valley Tonto Basin Clinic
Provider ID 007013199002
NPI: 1417432063
124 N Tewksbury Blvd
Young, AZ 85554
(928) 462-3435 EB, P, R
Ages: 0-99
Foulger, Jordan, PA, (M)
Cobre Valley Tonto Basin Clinic
Provider ID 007013199005
NPI: 1417432063
186 E Stephens Way
Tonto Basin, AZ 85553
(928) 479-2871 EB, P, R
Ages: 0-99
Foulger, Jordan, PA, (M)
Cobre Valley Tonto Basin Clinic
Provider ID 007013199001
NPI: 1417432063
5880 S Hospital Dr
Globe, AZ 85501
(928) 402-1165 EB, P, R
Ages: 0-99
Foulger, Jordan, PA, (M)
Cobre Valley Tonto Basin Clinic
Provider ID 007013199003
NPI: 1417432063
5994 S Hospital Dr
Globe, AZ 85501
(928) 425-7108 EB, P, R
Ages: 0-99
Gawelko, Gary E, PA, (M)
Goldfield Cardiovascular
Institute
Provider ID 003375148014
NPI: 1346577244
5882 S Hospital Dr Ste 1
Globe, AZ 85501
(480) 962-0101 E, EB, IB, P, R
Web address: www.goldfieldmed.co
m
Ages: 0-99
Hospital Affiliations:
Banner Payson Medical Center
Lunders, Shannon E, PA, (F)
North Country Healthcare
Provider ID 002995680006
NPI: 1689666844
708 Coeur D'alene Ste B
Payson, AZ 85541
(928) 468-8610 E, EB, IB, P, R
Ages: 0-99
Mcbride, Zachariah, PA, (M)
Cobre Valley Tonto Basin Clinic
Provider ID 006933721002
NPI: 1376028571
124 N Tewksbury Blvd
Young, AZ 85554
(928) 462-3435 EB, P, R
Ages: 0-99
Primary Care Providers / Proveedores De Cuidado Primario Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
41
CSAZ.18.999.01.9.017
Mcbride, Zachariah, PA, (M)
Cobre Valley Tonto Basin Clinic
Provider ID 006933721005
NPI: 1376028571
186 E Stephens Way
Tonto Basin, AZ 85553
(928) 479-2871 EB, P, R
Ages: 0-99
Mcbride, Zachariah, PA, (M)
Cobre Valley Tonto Basin Clinic
Provider ID 006933721001
NPI: 1376028571
5880 S Hospital Dr
Globe, AZ 85501
(928) 425-3246 EB, P, R
Ages: 0-99
Mcbride, Zachariah, PA, (M)
Cobre Valley Tonto Basin Clinic
Provider ID 006933721003
NPI: 1376028571
5994 S Hospital Dr
Globe, AZ 85501
(928) 425-7108 EB, P, R
Ages: 0-99
Mortenson, Duane S, PA, (M)
Sheftel & Associates Dermatology
Provider ID 003551572003
NPI: 1972719102
5886 S Hospital Dr
Globe, AZ 85501
(520) 293-5757 EB, P, R
Ages: 0-99
Nichols, Cameron L, PA, (M)
North Country Healthcare
Provider ID 003136968017
NPI: 1730411455
708 Coeur D'alene Ste B
Payson, AZ 85541
(928) 468-8610 E, EB, IB, P, R
Ages: 0-99
Peifer, Peter B, PA, (M)
Cobre Valley Regional Medical
Center
Provider ID 002318431004
NPI: 1093719577
124 N Tewksbury Blvd
Young, AZ 85554
(928) 462-3435 EB, P, R
Mo-We - 8:00 AM - 5:00 PM
Th - 9:00 AM - 4:30 PM
Fr - 9:00 AM - 12:00 PM
Ages: 0-99
Hospital Affiliations:
Cobre Valley Regional Medical
Center
Kingman Regional Medical Center
Peifer, Peter B, PA, (M)
Cobre Valley Regional Medical
Center
Provider ID 002318431001
NPI: 1093719577
5880 S Hospital Dr
Globe, AZ 85501
(928) 425-3261 EB, P, R
Languages Spoken:
Staff: Spanish
Ages: 0-99
Hospital Affiliations:
Cobre Valley Regional Medical
Center
Kingman Regional Medical Center
Peifer, Peter B, PA, (M)
Cobre Valley Regional Medical
Center
Provider ID 002318431002
NPI: 1093719577
5994 S Hospital Dr
Globe, AZ 85501
(928) 425-7108 EB, P, R
Languages Spoken:
Staff: Spanish
Mo-Fr - 7:00 AM - 5:00 PM
Ages: 0-99
Hospital Affiliations:
Cobre Valley Regional Medical
Center
Kingman Regional Medical Center
Porter, Levi, PA, (M)
Desert Pain & Rehab Specialists
Provider ID 003182455006
NPI: 1225111834
621 S Fifth St
Globe, AZ 85501
(928) 425-8273 E, EB, IB, P, R
Ages: 0-99
Queior, Paul, PA, (M)
North Country Healthcare
Provider ID 006229081013
NPI: 1144776055
708 S Coeur D Alene Ln Ste B
Payson, AZ 85541
(928) 468-8610 EB, P, R
Ages: 0-99
Hospital Affiliations:
Flagstaff Medical Center
Banner Boswell Medical Center
Richards, Bradley D, PA, (M)
Cobre Valley Regional Medical
Center
Provider ID 003313563003
NPI: 1790931210
124 N Tewksbury Blvd
Young, AZ 85554
(928) 462-3435 EB, P, R
Ages: 0-99
Hospital Affiliations:
Riverton Hospital
Arizona - Gila Primary Care Providers / Proveedores De Cuidado Primario
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
42
CSAZ.18.999.01.9.017
Richards, Bradley D, PA, (M)
Cobre Valley Regional Medical
Center
Provider ID 003313563001
NPI: 1790931210
5880 S Hospital Dr
Globe, AZ 85501
(928) 425-3261 EB, P, R
Ages: 0-99
Hospital Affiliations:
Riverton Hospital
Schmidt, Heidi M, PA, (F)
San Tan Allergy & Asthma
Provider ID 003255847028
NPI: 1194034942
708 S Coeur D Alene Ln Ste C
Payson, AZ 85541
(480) 626-6600 EB, P, R
Ages: 0-99
Hospital Affiliations:
Valleywise Health
Smith, Michael C, PA, (M)
Cobre Valley Tonto Basin Clinic
Provider ID 006317814003
NPI: 1336698851
124 N Tewksbury Blvd
Young, AZ 85554
(928) 462-3435 EB, P, R
Mo-We - 8:00 AM - 5:00 PM
Th - 9:00 AM - 4:30 PM
Fr - 9:00 AM - 12:00 PM
Ages: 0-99
Smith, Michael C, PA, (M)
Cobre Valley Tonto Basin Clinic
Provider ID 006317814006
NPI: 1336698851
186 E Stephens Way
Tonto Basin, AZ 85553
(928) 479-2871 EB, P, R
Ages: 0-99
Smith, Michael C, PA, (M)
Cobre Valley Tonto Basin Clinic
Provider ID 006317814002
NPI: 1336698851
5880 S Hospital Dr
Globe, AZ 85501
(928) 425-3246 EB, P, R
Mo-Fr - 8:00 AM - 4:30 PM
Ages: 0-99
Smith, Michael C, PA, (M)
Cobre Valley Tonto Basin Clinic
Provider ID 006317814004
NPI: 1336698851
5994 S Hospital Dr
Globe, AZ 85501
(928) 425-7108 EB, P, R
Mo-Fr - 7:00 AM - 5:00 PM
Ages: 0-99
Turner, Adam C, PA, (M)
Banner Primary Care Physicians
Arizona
Provider ID 007042343001
NPI: 1447725189
117 E Main St Ste A100
Payson, AZ 85541
(928) 596-4500 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Baywood Medical Center
Watabe, Jayson, PA, (M)
Cobre Valley Regional Medical
Center
Provider ID 006723347001
NPI: 1417359605
5880 S Hospital Dr
Globe, AZ 85501
(928) 425-3261 EB, P, R
Ages: 0-99
Watson, Joy M, PA, (F)
Hope Family Care Ctr
Provider ID 003124523009
NPI: 1790958866
285 N Broad St
Globe, AZ 85501
(928) 425-8200 EB, P, R
Ages: 0-99
White, Shari J, PA, (F)
North Country Healthcare
Provider ID 003215969004
NPI: 1447222930
708 Coeur D'alene Ste B
Payson, AZ 85541
(928) 468-8610 E, EB, IB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Wyma, Mark, PA, (M)
Cobre Valley Tonto Basin Clinic
Provider ID 007013235002
NPI: 1336612852
124 N Tewksbury Blvd
Young, AZ 85554
(928) 462-3435 EB, P, R
Ages: 0-99
Wyma, Mark, PA, (M)
Cobre Valley Tonto Basin Clinic
Provider ID 007013235005
NPI: 1336612852
186 E Stephens Way
Tonto Basin, AZ 85553
(928) 479-2871 EB, P, R
Ages: 0-99
Primary Care Providers / Proveedores De Cuidado Primario Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
43
CSAZ.18.999.01.9.017
Wyma, Mark, PA, (M)
Cobre Valley Tonto Basin Clinic
Provider ID 007013235001
NPI: 1336612852
5880 S Hospital Dr
Globe, AZ 85501
(928) 402-1165 EB, P, R
Ages: 0-99
Wyma, Mark, PA, (M)
Cobre Valley Tonto Basin Clinic
Provider ID 007013235003
NPI: 1336612852
5994 S Hospital Dr
Globe, AZ 85501
(928) 425-7108 EB, P, R
Ages: 0-99
Yu, Stephanie P, PA, (F)
Canyonlands Community Health
Care Vista
Provider ID 006604379004
NPI: 1356853824
5860 S Hospital Dr Ste 102
Globe, AZ 85501
(928) 402-0491 E, EB, G, IB, P,
PL, R, T
Languages Spoken:
Provider: Cantonese, Mandarin,
Spanish
Ages: 0-99
Hospital Affiliations:
Valleywise Health
Areas of Expertise: Developmental
Disabilities
Rural Health Clinic / Clínica De
Salud Rural
Pleasant Valley Comm Medi
Provider ID 005384771002
NPI: 1811962848
124 N Tewksbury Blvd
Young, AZ 85554
(928) 462-3435 EB, P, R
Web address: www.cvrmc.org
Ages: 0-99
Pinal
Family Nurse Practitioner /
Enfermera De Familia
Barry, Courtney J, NP, (F)
Sun Life Family Health Center
Provider ID 003053262002
NPI: 1952419202
23 Mcnabb Pkwy
San Manuel, AZ 85631
(520) 385-2234 EB, P, R
Ages: 0-99
Hospital Affiliations:
Samaritan Pacific Communities
Curry, Irene S, FNP, (F)
Sun Life Family Health Center
Provider ID 005206220025
NPI: 1801205471
1870 W American Way
Oracle, AZ 85623
(520) 896-2092 E, EB, IB, P, R,
RE, S, T
Ages: 0-99
Curry, Irene S, FNP, (F)
Sun Life Family Health Center
Provider ID 005206220023
NPI: 1801205471
23 S Mcnab Pkwy
San Manuel, AZ 85631
(520) 835-2234 EB, P, R
Ages: 0-99
Griffin, Kelly D, NP, (F)
Sun Life Family Health Center
Provider ID 005453597001
NPI: 1437541091
23 Mcnabb Pkwy
San Manuel, AZ 85631
(520) 385-2234 EB, P, R
Ages: 0-99
Hoffsten, Pilar M, FNP, (F)
Sun Life Family Health Center
Provider ID 004260775027
NPI: 1386074284
1040 W American Ave
Oracle, AZ 85623
(520) 896-2092 EB, P, R
Ages: 0-99
Rodgers Herington, Debra A, NP,
(F)
Sun Life Family Health Center
Provider ID 004773367009
NPI: 1821352410
1870 W American Way
Oracle, AZ 85623
(520) 896-2092 E, EB, IB, P, R,
RE, S, T
Ages: 0-99
Wilson, Robin D, FNP, (F)
Sun Life Family Health Center
Provider ID 005079697013
NPI: 1700291440
1870 W American Way
Oracle, AZ 85623
(520) 896-2092 E, EB, IB, P, R,
RE, S, T
Ages: 18-99
Family Practice / Medicina
Familiar
Arizona - Pinal Primary Care Providers / Proveedores De Cuidado Primario
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
44
CSAZ.18.999.01.9.017
Chukwurah, Chinwe N, MD, (F),
B
Sun Life Family Health Center
Provider ID 002878845008
NPI: 1467637140
1870 W American Way
Oracle, AZ 85623
(520) 896-2092 E, EB, IB, P, R,
RE, S, T
Languages Spoken:
Provider: Russian
Ages: 0-99
Hospital Affiliations:
Dlp Maria Parham Medical Center
Granville Medical Center
Chukwurah, Chinwe N, MD, (F),
B
Sun Life Family Health Center
Provider ID 002878845007
NPI: 1467637140
23 Mcnabb Pkwy
San Manuel, AZ 85631
(520) 385-2234 EB, P, R
Languages Spoken:
Provider: Russian
Ages: 0-99
Hospital Affiliations:
Dlp Maria Parham Medical Center
Granville Medical Center
Crawford, John T, DO, (M), B
Sun Life Family Health Center
Provider ID 001888678003
NPI: 1154382596
23 S Mcnab Pkwy
San Manuel, AZ 85631
(520) 385-2234 EB, P, R
Ages: 0-99
Hospital Affiliations:
Casa Grande Regional Med Ctr
Banner Casa Grande Medical
Center
Northwest Medical Center
Geyer, Katelyn A, DO, (F), B
Sun Life Family Health Center
Provider ID 006811675005
NPI: 1144617812
1870 W American Way
Oracle, AZ 85623
(520) 896-2092 E, EB, IB, P, R,
RE, S, T
Ages: 0-99
Nayyar, Deepak, MD, (M)
Sun Life Family Health Center
Provider ID 003105494006
NPI: 1790900827
23 Mcnabb Pkwy
San Manuel, AZ 85631
(520) 385-2234 EB, P, R
Ages: 0-99
Thompson, Coralee G, MD, (F)
Sun Life Family Health Center
Provider ID 002196126001
NPI: 1659547636
1870 W American Ave
Oracle, AZ 85623
(520) 896-2092 EB, P, R
Ages: 0-99
Hospital Affiliations:
Casa Grande Regional Med Ctr
Banner Casa Grande Medical
Center
Thompson, Coralee G, MD, (F)
Sun Life Family Health Center
Provider ID 002196126002
NPI: 1659547636
23 S Mcnab Pkwy
San Manuel, AZ 85631
(520) 385-2234 EB, P, R
Ages: 0-99
Hospital Affiliations:
Casa Grande Regional Med Ctr
Banner Casa Grande Medical
Center
Federally Qualified Health Care
Agency / Agencia De Salud
Federalmente Calificados
Sun Life Family - Oracle
Provider ID 005376911001
NPI: 1902018856
1870 W American Way
Oracle, AZ 85623
(520) 896-2092 E, EB, IB, P, R,
RE, S, T
Does Not Accept New Patients
Ages: 0-99
Sun Life Family Health Ct
Provider ID 005370809007
NPI: 1689778623
1870 W American Way
Oracle, AZ 85623
(520) 896-2092 E, EB, IB, P, R,
RE, S, T
Does Not Accept New Patients
Ages: 0-99
Sun Life Family Health Ct
Provider ID 005370809025
NPI: 1689778623
23 S Mcnab Pkwy
San Manuel, AZ 85631
(520) 385-2234 EB, P, R
Does Not Accept New Patients
Ages: 0-99
Sun Life Family-San Manue
Provider ID 005376915001
NPI: 1467666206
23 S Mcnab Pkwy
San Manuel, AZ 85631
(520) 385-2234 EB, P, R
Does Not Accept New Patients
Ages: 0-99
Internal Medicine / Medicina
Interna
Primary Care Providers / Proveedores De Cuidado Primario Arizona - Pinal
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
45
CSAZ.18.999.01.9.017
Tuli, Ajay, MD, (M), B
Pima Heart Physicians
Provider ID 002241188021
NPI: 1093793267
23 S Mcnab Pkwy
San Manuel, AZ 85631
(520) 297-9060 EB, P, R
Ages: 0-99
Hospital Affiliations:
Tucson Medical Center
Carondelet St Marys Hospital
Northwest Medical Center
Oro Valley Hospital
Tuli, Ajay, MD, (M), B
Pima Heart Physicians
Provider ID 002241188024
NPI: 1093793267
25 S Mcnab Pkwy
San Manuel, AZ 85631
(520) 297-9060 EB, P, R
Ages: 0-99
Hospital Affiliations:
Tucson Medical Center
Carondelet St Marys Hospital
Northwest Medical Center
Oro Valley Hospital
Nurse Practitioner / Enfermera
Especialista
Barry, Courtney J, NP, (F)
Sun Life Family Health Center
Provider ID 003053262002
NPI: 1952419202
23 Mcnabb Pkwy
San Manuel, AZ 85631
(520) 385-2234 EB, P, R
Ages: 0-99
Hospital Affiliations:
Samaritan Pacific Communities
Brown, Melissa L, NP, (F)
Sun Life Family Health Center
Provider ID 005453565003
NPI: 1578959896
1870 W American Way
Oracle, AZ 85623
(520) 896-2092 E, EB, IB, P, R,
RE, S, T
Ages: 0-99
Hospital Affiliations:
Chandler Regional Medical Center
Currier, Samantha L, NP, (F)
Sun Life Family Health Center
Provider ID 006832464005
NPI: 1750735023
1870 W American Way
Oracle, AZ 85623
(520) 896-2092 E, EB, IB, P, R,
RE, S, T
Ages: 0-99
Currier, Samantha L, NP, (F)
Sun Life Family Health Center
Provider ID 006832464003
NPI: 1750735023
23 S Mcnab Pkwy
San Manuel, AZ 85631
(520) 385-2234 EB, P, R
Ages: 0-99
Dardy, Sandra K, NP, (F)
Sun Life Family Health Center
Provider ID 007139550014
NPI: 1942729413
1040 W American Ave
Oracle, AZ 85623
(520) 896-2092 EB, P, R
Ages: 18-99
Dardy, Sandra K, NP, (F)
Sun Life Family Health Center
Provider ID 007139550003
NPI: 1942729413
1870 W American Way
Oracle, AZ 85623
(520) 896-2092 E, EB, IB, P, R,
RE, S, T
Ages: 18-99
Dardy, Sandra K, NP, (F)
Sun Life Family Health Center
Provider ID 007139550002
NPI: 1942729413
23 S Mcnab Pkwy
San Manuel, AZ 85631
(520) 385-2234 EB, P, R
Ages: 18-99
Griffin, Kelly D, NP, (F)
Sun Life Family Health Center
Provider ID 005453597001
NPI: 1437541091
23 Mcnabb Pkwy
San Manuel, AZ 85631
(520) 385-2234 EB, P, R
Ages: 0-99
Kimble, Guatemala D, NP, (M)
Sun Life Family Health Center
Provider ID 006742963004
NPI: 1427593326
1870 W American Way
Oracle, AZ 85623
(520) 896-2092 E, EB, IB, P, R,
RE, S, T
Ages: 18-99
Arizona - Pinal Primary Care Providers / Proveedores De Cuidado Primario
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
46
CSAZ.18.999.01.9.017
Kimble, Guatemala D, NP, (M)
Sun Life Family Health Center
Provider ID 006742963002
NPI: 1427593326
23 S Mcnab Pkwy
San Manuel, AZ 85631
(520) 385-2234 EB, P, R
Ages: 18-99
Manor, Cynthia, NP, (F)
Sun Life Family Health Center
Provider ID 007220447002
NPI: 1679128466
23 S Mcnab Pkwy
San Manuel, AZ 85631
(520) 835-2234 EB, P, R
Ages: 18-99
Mcdevitt, Kyle K, NP, (F)
Sun Life Family Health Center
Provider ID 006299731008
NPI: 1902356074
1870 W American Way
Oracle, AZ 85623
(520) 896-2092 E, EB, IB, P, R,
RE, S, T
Ages: 18-99
Hospital Affiliations:
Palo Alto County Hospital
Mcdevitt, Kyle K, NP, (F)
Sun Life Family Health Center
Provider ID 006299731006
NPI: 1902356074
23 S Mcnab Pkwy
San Manuel, AZ 85631
(520) 385-2234 EB, P, R
Ages: 18-99
Hospital Affiliations:
Palo Alto County Hospital
Monson, Melissa M, NP, (F)
Sun Life Family Health Center
Provider ID 006876530005
NPI: 1255826806
1870 W American Way
Oracle, AZ 85623
(520) 896-2092 E, EB, IB, P, R,
RE, S, T
Ages: 18-99
Monson, Melissa M, NP, (F)
Sun Life Family Health Center
Provider ID 006876530003
NPI: 1255826806
23 S Mcnab Pkwy
San Manuel, AZ 85631
(520) 385-2234 EB, P, R
Ages: 18-99
Ochieng, Judith M, NP, (F)
Sun Life Family Health Center
Provider ID 003742163006
NPI: 1063841666
1870 W American Way
Oracle, AZ 85623
(520) 896-2092 E, EB, IB, P, R,
RE, S, T
Ages: 18-99
Ochieng, Judith M, NP, (F)
Sun Life Family Health Center
Provider ID 003742163004
NPI: 1063841666
23 S Mcnab Pkwy
San Manuel, AZ 85631
(520) 385-2234 EB, P, R
Ages: 18-99
Philip, Selin, FNP, (F)
Sun Life Family Health Center
Provider ID 006585113004
NPI: 1609316546
1870 W American Way
Oracle, AZ 85623
(520) 896-2092 E, EB, IB, P, R,
RE, S, T
Ages: 18-99
Quesada, Nikki C, NP, (F)
Sun Life Family Health Center
Provider ID 007205002014
NPI: 1114494150
1040 W American Ave
Oracle, AZ 85623
(520) 896-2092 EB, P, R
Ages: 18-99
Quesada, Nikki C, NP, (F)
Sun Life Family Health Center
Provider ID 007205002015
NPI: 1114494150
1080 W American Ave
Oracle, AZ 85623
(520) 896-2092 EB, P, R
Ages: 18-99
Quesada, Nikki C, NP, (F)
Sun Life Family Health Center
Provider ID 007205002003
NPI: 1114494150
1870 W American Ave
Oracle, AZ 85623
(520) 896-2092 EB, P, R
Ages: 18-99
Primary Care Providers / Proveedores De Cuidado Primario Arizona - Pinal
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
47
CSAZ.18.999.01.9.017
Rodgers Herington, Debra A, NP,
(F)
Sun Life Family Health Center
Provider ID 004773367009
NPI: 1821352410
1870 W American Way
Oracle, AZ 85623
(520) 896-2092 E, EB, IB, P, R,
RE, S, T
Ages: 0-99
Taylor, Kimberly E, FNP, (F)
Sun Life Family Health Center
Provider ID 002462343035
NPI: 1447446471
1870 W American Way
Oracle, AZ 85623
(520) 896-2092 E, EB, IB, P, R,
RE, S, T
Ages: 18-99
Wilson, Robin D, FNP, (F)
Sun Life Family Health Center
Provider ID 005079697013
NPI: 1700291440
1870 W American Way
Oracle, AZ 85623
(520) 896-2092 E, EB, IB, P, R,
RE, S, T
Ages: 18-99
Xie, Bing, FNP, (F)
Sun Life Family Health Center
Provider ID 006355306003
NPI: 1326585845
1870 W American Way
Oracle, AZ 85623
(520) 896-2092 E, EB, IB, P, R,
RE, S, T
Languages Spoken:
Provider: Chinese
Ages: 18-99
Xie, Bing, FNP, (F)
Sun Life Family Health Center
Provider ID 006355306002
NPI: 1326585845
23 S Mcnab Pkwy
San Manuel, AZ 85631
(520) 385-2234 EB, P, R
Languages Spoken:
Provider: Chinese
Ages: 18-99
Pediatrics / Pediatría
Liao, Tina Y, MD, (F)
Sun Life Family Health Center
Provider ID 002658872008
NPI: 1063636512
1870 W American Way
Oracle, AZ 85623
(520) 896-2092 E, EB, IB, P, R,
RE, S, T
Ages: 0-18
Hospital Affiliations:
Banner Health Arizona
Phx Childrens Hospital
Banner Gateway Medical Center
Raposas, Stella C, MD, (F), B
Sun Life Family Health Center
Provider ID 002675696011
NPI: 1538269345
1870 W American Way
Oracle, AZ 85623
(520) 896-2092 E, EB, IB, P, R,
RE, S, T
Ages: 0-18
Hospital Affiliations:
Rcch Trios Health
Raposas, Stella C, MD, (F), B
Sun Life Family Health Center
Provider ID 002675696006
NPI: 1538269345
23 S Mcnab Pkwy
San Manuel, AZ 85631
(520) 385-2234 EB, P, R
Ages: 0-18
Hospital Affiliations:
Rcch Trios Health
Tunuguntla, Rashmi, DO, (F)
Sun Life Family Health Center
Provider ID 006846784004
NPI: 1639543572
1870 W American Way
Oracle, AZ 85623
(520) 896-2092 E, EB, IB, P, R,
RE, S, T
Languages Spoken:
Provider: Spanish, Telugu
Ages: 0-18
Physician Assistant / Asistente
Médico
Carpenter, Derek B, PA, (M)
Sun Life Family Health Center
Provider ID 005237843003
NPI: 1114320959
23 S Mcnab Pkwy
San Manuel, AZ 85631
(520) 385-2234 EB, P, R
Ages: 0-99
Mercado-Depaz, Disnilda L, PA,
(F)
Sun Life Family Health Center
Provider ID 006413034006
NPI: 1669728655
1870 W American Way
Oracle, AZ 85623
(520) 896-2092 E, EB, IB, P, R,
RE, S, T
Ages: 0-99
Arizona - Pinal Primary Care Providers / Proveedores De Cuidado Primario
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
48
CSAZ.18.999.01.9.017
Mercado-Depaz, Disnilda L, PA,
(F)
Sun Life Family Health Center
Provider ID 006413034004
NPI: 1669728655
23 S Mcnab Pkwy
San Manuel, AZ 85631
(520) 835-2234 EB, P, R
Ages: 0-99
Nichols, Logan R, PA, (M)
Sun Life Family Health Center
Provider ID 006955859003
NPI: 1871062125
1870 W American Way
Oracle, AZ 85623
(520) 896-2092 E, EB, IB, P, R,
RE, S, T
Ages: 0-99
California
Riverside
Pediatrics / Pediatría
Tong, Shumei, MD, (F)
Tong Shumei
Provider ID 001961326001
NPI: 1568481554
149 W Hobsonway
Blythe, CA 92225
(760) 922-7337 EB, P, R
Mo-Fr - 8:30 AM - 5:30 PM
Ages: 0-18
Hospital Affiliations:
Palo Verde Hospital
Nevada
Clark
Internal Medicine / Medicina
Interna
Gandhi, Zahabia T, MD, (F), B
Advanced Pulmon Sleep Disord &
Int Med
Provider ID 002255369002
NPI: 1538125240
1301 Bertha Howe Ave Ste 10
Mesquite, NV 89027
(435) 688-7770
Languages Spoken:
Provider: Guarani, Hindi
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Utah
Kane
Family Practice / Medicina
Familiar
Bowman, Jonathan C, MD, (M)
Kane County Medical Clinic
Provider ID 002414889005
NPI: 1619047362
355 N Main St
Kanab, UT 84741
(435) 644-4100 EB, IB, P, R
Mo,We,Fr - 8:30 AM - 4:30 PM
Tu,Th - 8:30 AM - 12:00 PM
Ages: 0-99
Hospital Affiliations:
Kane County Hospital
Hollingshead, Bryson J, DO, (M)
Revere Health
Provider ID 006140615003
NPI: 1124432992
355 N Main St
Kanab, UT 84741
(435) 644-4100 EB, IB, P, R
Ages: 0-99
Hospital Affiliations:
Kane County Hospital
Root, Eric J, DO, (M)
Revere Health
Provider ID 006859866001
NPI: 1528445202
355 N Main St
Kanab, UT 84741
(435) 644-4100 EB, IB, P, R
Ages: 0-99
Hospital Affiliations:
Kane County Hospital
Washington
Family Practice / Medicina
Familiar
Barton, Scott D, MD, (M), B
Revere Health
Provider ID 001903209005
NPI: 1376690180
736 S 900 E Ste 203
Saint George, UT 84790
(435) 673-6131 EB, P, R
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Primary Care Providers / Proveedores De Cuidado Primario Utah - Washington
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
49
CSAZ.18.999.01.9.017
Chamberlain, Howard L, MD,
(M)
Revere Health
Provider ID 001374555001
NPI: 1306951504
736 S 900 E Ste 203
Saint George, UT 84790
(435) 673-6131 EB, P, R
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Hubbard, Jonathan P, DO, (M), B
Revere Health
Provider ID 001981874001
NPI: 1609894922
736 S 900 E Ste 203
Saint George, UT 84790
(435) 673-6131 EB, P, R
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Lunt, Bryce C, MD, (M)
Revere Health
Provider ID 006795597001
NPI: 1396127635
736 S 900 E Ste 203
Saint George, UT 84790
(435) 673-6131 EB, P, R
Mo-Fr - 9:00 AM - 5:00 PM
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Pendleton, Gus C, MD, (M), B
Revere Health
Provider ID 001360147002
NPI: 1649361874
736 S 900 E Ste 203
Saint George, UT 84790
(435) 673-6131 EB, P, R
Ages: 0-99
Hospital Affiliations:
Sanpete Valley Hospital
Dixie Regional Medical Center
Stratford, C K, MD, (M)
Revere Health
Provider ID 001703276001
NPI: 1275688228
736 S 900 E Ste 203
Saint George, UT 84790
(435) 673-6131 EB, P, R
Mo-Fr - 9:00 AM - 5:00 PM
Sa - 9:00 AM - 2:00 PM
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Internal Medicine / Medicina
Interna
Gandhi, Zahabia T, MD, (F), B
Advanced Pulmon Sleep Disord &
Int Med
Provider ID 002255369001
NPI: 1538125240
640 E 700 S Ste 105
Saint George, UT 84770
(435) 688-7770 EB, P, R
Languages Spoken:
Provider: Guarani, Hindi
Staff: Spanish
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Nurse Practitioner / Enfermera
Especialista
Heaton, Rex, NP, (M)
Revere Health
Provider ID 004271065006
NPI: 1477627917
2019 E Riverside Dr Ste A200
Saint George, UT 84790
(435) 628-9298 EB, P, R
Ages: 0-99
Pediatrics / Pediatría
Nilson, Wendell T, MD, (M), B
Cache Pediatric Clinic
Provider ID 000808720001
NPI: 1205883576
1240 E 100 S Ste 14
Saint George, UT 84790
(435) 634-0055 EB, P, R
Ages: 0-18
Hospital Affiliations:
Dixie Regional Medical Center
Logan Regional Hospital
Nilson, Wendell T, MD, (M), B
Cache Pediatric Clinic
Provider ID 000808720002
NPI: 1205883576
1490 E Foremaster Dr Ste 130
Saint George, UT 84790
(435) 634-0055 EB, P, R
Mo-Th - 8:00 AM - 7:00 PM
Fr - 8:00 AM - 5:00 PM
Sa - 9:00 AM - 12:00 PM
Ages: 0-18
Hospital Affiliations:
Dixie Regional Medical Center
Logan Regional Hospital
Utah - Washington Primary Care Providers / Proveedores De Cuidado Primario
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
50
CSAZ.18.999.01.9.017
Twiggs, Jerry D, MD, (M), B
Dixie Pediatrics
Provider ID 000804905001
NPI: 1972583680
1240 E 100 S Ste 14
St George, UT 84790
(435) 628-8232 EB, P, R
Languages Spoken:
Provider: Spanish
Mo-Fr - 9:30 AM - 5:00 PM
Ages: 0-18
Hospital Affiliations:
Dixie Regional Medical Center
Delta Community Hospital
Physician Assistant / Asistente
Médico
Bean, Thomas S, PA, (M)
Revere Health
Provider ID 003516569004
NPI: 1346358454
736 S 900 E Ste 203
Saint George, UT 84790
(435) 673-6131 EB, P, R
Ages: 0-99
Primary Care Providers / Proveedores De Cuidado Primario Utah - Washington
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
51
CSAZ.18.999.01.9.017
Arizona
Gila
Allergy & Immunology / Alergia
E Inmunología
Hill, Jennifer L, MD, (F)
San Tan Allergy & Asthma
Provider ID 005176942002
NPI: 1497035604
708 S Coeur D Alene Ln Ste C
Payson, AZ 85541
(480) 626-6600 EB, P, R
Cultural Competency: Y
Ages: 0-99
Hospital Affiliations:
University Medical Center
Banner University Med Ctr
Tucson Campus
Jain, Neal, MD, (M), B
San Tan Allergy & Asthma
Provider ID 002437343004
NPI: 1356390512
708 S Coeur D Alene Ln Ste C
Payson, AZ 85541
(480) 626-6600 EB, P, R
Languages Spoken:
Provider: Spanish
Cultural Competency: Y
Ages: 0-18
Hospital Affiliations:
St Marys Hosp Med Ctr Madison
Ssm Health St Marys Hospital
Madison
Valleywise Health
Banner Desert Medical Center
Shimamoto, Sam R, MD, (M), B
San Tan Allergy & Asthma
Provider ID 002245188001
NPI: 1073587382
708 S Coeur D Alene Ln Ste C
Payson, AZ 85541
(480) 626-6600 EB, P, R
Languages Spoken:
Provider: Spanish
Cultural Competency: Y
Ages: 0-99
Hospital Affiliations:
Banner Desert Medical Center
Cardiology / Cardiología
Askari, Ali A, MD, (M), B
Ali A Askari Md
Provider ID 000940356004
NPI: 1760554919
1106 N Beeline Hwy
Payson, AZ 85541
(928) 474-5286 EB, P, R
Languages Spoken:
Provider: Farsi, Persian, Spanish
Ages: 0-99
Hospital Affiliations:
St Lukes Medical Center
Banner Payson Medical Center
Select Specialty Hos-phoenix
Select Specialty Hospital
Banner Univ Medical Cntr
Phoenix Campus
St Josephs Hsp And Med Ctr
Kindred Hospital Arizona Phoenix
Kindred Hospital Az-northwest
Phoenix
Jaffe, William M, DO, (M), B
Vhs Outpatient Clinics
Provider ID 003061186010
NPI: 1083648158
708 S Coeur D Alene Ln Ste 1
Payson, AZ 85541
(928) 472-7440 EB, P, R
Languages Spoken:
Provider: Spanish
Cultural Competency: Y
Ages: 0-99
Hospital Affiliations:
Casa Grande Regional Med Ctr
Banner Casa Grande Medical
Center
Dominican Santa Cruz Hospital
Maricopa Medical Center
Banner Univ Medical Cntr
Phoenix Campus
Jaffe, William M, DO, (M), B
Vhs Outpatient Clinics
Provider ID 003061186010
NPI: 1083648158
708 S Coeur D Alene Ln Ste A
Payson, AZ 85541
(928) 472-7440 EB, P, R
Languages Spoken:
Provider: Spanish
Cultural Competency: Y
Ages: 0-99
Hospital Affiliations:
Casa Grande Regional Med Ctr
Banner Casa Grande Medical
Center
Dominican Santa Cruz Hospital
Maricopa Medical Center
Banner Univ Medical Cntr
Phoenix Campus
Arizona - Gila Specialists / Especialistas
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
52
CSAZ.18.999.01.9.017
Memon, Abdul Q, MD, (M)
Abdul Memon Md
Provider ID 001870839013
NPI: 1093781346
5882 S Hospital Dr Ste 1
Globe, AZ 85501
(480) 748-4238 E, EB, IB, P, R
Languages Spoken:
Provider: Hindi, Spanish, Urdu
Mo-Th - 8:00 AM - 5:00 PM
Fr - 8:00 AM - 12:00 PM
Cultural Competency: Y
Ages: 0-99
Hospital Affiliations:
White Mountain Regional Med
Ctr
Cobre Valley Regional Medical
Center
Providence Sacred Heart Med Ctr
& Child
Multicare Deaconess Hospital
Summit Regional Medical Center
Banner Desert Medical Center
Chandler Regional Medical Center
Mix, Michelle, MD, (F), B
Vhs Outpatient Clinics
Provider ID 003549960008
NPI: 1831385533
708 S Coeur D Alene Ln Ste A
Payson, AZ 85541
(928) 472-7440 EB, P, R
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Banner Thunderbird Medical
Center
Jcl Dv Hospital
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Valleywise Health
Banner Univ Medical Cntr
Phoenix Campus
Honorhealth Scottsdale Shea
Medical Ctr
Morgan, John M, MD, (M), B
Vhs Outpatient Clinics
Provider ID 001949828013
NPI: 1407890353
708 S Coeur D Alene Ln Ste A
Payson, AZ 85541
(928) 472-7440 EB, P, R
Languages Spoken:
Provider: French
Cultural Competency: Y
Ages: 0-99
Hospital Affiliations:
St Lukes Medical Center
Banner Page Hospital
Valleywise Health
Abrazo Arizona Heart Hospital
Banner Univ Medical Cntr
Phoenix Campus
St Josephs Hsp And Med Ctr
Patil, Arun S, MD, (M), B
Integrated Medical Services
Provider ID 000925056009
NPI: 1093955908
111 W Cedar Ln Ste A
Payson, AZ 85541
(623) 433-0202 E, EB, IB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
St Josephs Hsp And Med Ctr
West Valley Hospital Medical
Center
Abrazo West Campus
Banner Estrella Medical Center
Vakil, Hiva, MD, (M), B
Integrated Medical Services
Provider ID 002780020007
NPI: 1356480172
111 W Cedar Ln Ste A
Payson, AZ 85541
(623) 433-0202 E, EB, IB, P, R
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
Abrazo Arrowhead Campus
Maryvale Hospital Medical Center
Abrazo Maryvale Campus
Abrazo Scottsdale Campus
Jcl Dv Hospital
Select Specialty Hos-phoenix
Banner Thunderbird Medical
Center
Cardiovascular Disease /
Enfermedad Cardiovascular
Specialists / Especialistas Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
53
CSAZ.18.999.01.9.017
Alkhatib, Basil J, MD, (M), B
Vhs Outpatient Clinics
Provider ID 005986240008
NPI: 1083977599
708 S Coeur D Alene Ln Ste A
Payson, AZ 85541
(928) 472-7440 EB, P, R
Languages Spoken:
Provider: Arabic
Ages: 0-99
Hospital Affiliations:
St Josephs Hospital & Med Ctr
Chandler Regional Medical Center
Askari, Ali A, MD, (M), B
Ali A Askari Md
Provider ID 000940356004
NPI: 1760554919
1106 N Beeline Hwy
Payson, AZ 85541
(928) 474-5286 EB, P, R
Languages Spoken:
Provider: Farsi, Persian, Spanish
Ages: 0-99
Hospital Affiliations:
St Lukes Medical Center
Banner Payson Medical Center
Select Specialty Hos-phoenix
Select Specialty Hospital
Banner Univ Medical Cntr
Phoenix Campus
St Josephs Hsp And Med Ctr
Kindred Hospital Arizona Phoenix
Kindred Hospital Az-northwest
Phoenix
Bahu, Marwan M, MD, (M), B
Vhs Outpatient Clinics
Provider ID 001800566007
NPI: 1114920618
708 S Coeur D Alene Ln Ste A
Payson, AZ 85541
(928) 472-7440 EB, P, R
Languages Spoken:
Provider: Arabic
Ages: 0-99
Hospital Affiliations:
Banner Page Hospital
Banner Boswell Medical Center
Valleywise Health
Abrazo Arizona Heart Hospital
Maricopa Medical Center
Banner Univ Medical Cntr
Phoenix Campus
Scttsdle Hlth Osb
Honorhealth Scottsdale Shea
Medical Ctr
Byrne, Timothy J, DO, (M), B
Vhs Outpatient Clinics
Provider ID 001427442011
NPI: 1376585232
708 S Coeur D Alene Ln Ste A
Payson, AZ 85541
(928) 472-7440 EB, P, R
Cultural Competency: Y
Ages: 0-99
Hospital Affiliations:
St Lukes Medical Center
Banner Page Hospital
Wickenburg Community Hospital
Valleywise Health
Abrazo Arizona Heart Hospital
Banner Univ Medical Cntr
Phoenix Campus
St Josephs Hsp And Med Ctr
Oasis Hospital
Cherukuri, Madhavagopal V,
MD, (M), B
Vhs Outpatient Clinics
Provider ID 002353157016
NPI: 1104860337
708 S Coeur D Alene Ln Ste 1
Payson, AZ 85541
(928) 472-7440 EB, P, R
Cultural Competency: Y
Ages: 0-99
Hospital Affiliations:
St Lukes Medical Center
Valleywise Health
Tempe St Lukes Hosp A Campus
Of St Lukes
Abrazo Arizona Heart Hospital
Banner Univ Medical Cntr
Phoenix Campus
St Josephs Hsp And Med Ctr
Banner Behavioral Health
Hospital
Cherukuri, Madhavagopal V,
MD, (M), B
Vhs Outpatient Clinics
Provider ID 002353157016
NPI: 1104860337
708 S Coeur D Alene Ln Ste A
Payson, AZ 85541
(928) 472-7440 EB, P, R
Cultural Competency: Y
Ages: 0-99
Hospital Affiliations:
St Lukes Medical Center
Valleywise Health
Tempe St Lukes Hosp A Campus
Of St Lukes
Abrazo Arizona Heart Hospital
Banner Univ Medical Cntr
Phoenix Campus
St Josephs Hsp And Med Ctr
Banner Behavioral Health
Hospital
Arizona - Gila Specialists / Especialistas
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
54
CSAZ.18.999.01.9.017
Jaffe, William M, DO, (M), B
Vhs Outpatient Clinics
Provider ID 003061186010
NPI: 1083648158
708 S Coeur D Alene Ln Ste 1
Payson, AZ 85541
(928) 472-7440 EB, P, R
Languages Spoken:
Provider: Spanish
Cultural Competency: Y
Ages: 0-99
Hospital Affiliations:
Casa Grande Regional Med Ctr
Banner Casa Grande Medical
Center
Dominican Santa Cruz Hospital
Maricopa Medical Center
Banner Univ Medical Cntr
Phoenix Campus
Jaffe, William M, DO, (M), B
Vhs Outpatient Clinics
Provider ID 003061186010
NPI: 1083648158
708 S Coeur D Alene Ln Ste A
Payson, AZ 85541
(928) 472-7440 EB, P, R
Languages Spoken:
Provider: Spanish
Cultural Competency: Y
Ages: 0-99
Hospital Affiliations:
Casa Grande Regional Med Ctr
Banner Casa Grande Medical
Center
Dominican Santa Cruz Hospital
Maricopa Medical Center
Banner Univ Medical Cntr
Phoenix Campus
Jebaily, Nicholas X, MD, (M), B
Biltmore Cardiology
Provider ID 003709522002
NPI: 1710206909
708 S Coeur D Alene Ln Ste 1
Payson, AZ 85541
(602) 952-0002 EB, P, R
Cultural Competency: Y
Ages: 0-99
Hospital Affiliations:
Banner Payson Medical Center
Banner Univ Medical Cntr
Phoenix Campus
St Josephs Hsp And Med Ctr
Klein, Neal A, MD, (M), B
Vhs Outpatient Clinics
Provider ID 000062010021
NPI: 1639111743
708 S Coeur D Alene Ln Ste A
Payson, AZ 85541
(928) 472-7440 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
St Lukes Medical Center
Banner Page Hospital
Valleywise Health
Abrazo Arizona Heart Hospital
Banner Univ Medical Cntr
Phoenix Campus
St Josephs Hsp And Med Ctr
Oasis Hospital
Loli, Akil I, MD, (M), B
Vhs Outpatient Clinics
Provider ID 002302374017
NPI: 1962453803
708 S Coeur D Alene Ln Ste A
Payson, AZ 85541
(928) 472-7440 EB, P, R
Languages Spoken:
Provider: Albanian (Tosk),
Italian, Spanish
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
Casa Grande Regional Med Ctr
Banner Casa Grande Medical
Center
Valleywise Health
Banner Univ Medical Cntr
Phoenix Campus
St Josephs Hsp And Med Ctr
Maki, Peter C, MD, (M), B
Vhs Outpatient Clinics
Provider ID 000623695008
NPI: 1306886775
708 S Coeur D Alene Ln Ste 1
Payson, AZ 85541
(928) 472-7440 EB, P, R
Languages Spoken:
Provider: Spanish
Cultural Competency: Y
Ages: 0-99
Hospital Affiliations:
St Lukes Medical Center
Banner Page Hospital
Valleywise Health
Abrazo Arizona Heart Hospital
Select Specialty Hospital Western
Mo
Banner Univ Medical Cntr
Phoenix Campus
Scttsdle Hlth Osb
Honorhealth Scottsdale Shea
Medical Ctr
Specialists / Especialistas Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
55
CSAZ.18.999.01.9.017
Memon, Abdul Q, MD, (M), B
Abdul Memon Md
Provider ID 001870839013
NPI: 1093781346
5882 S Hospital Dr Ste 1
Globe, AZ 85501
(480) 748-4238 E, EB, IB, P, R
Languages Spoken:
Provider: Hindi, Spanish, Urdu
Mo-Th - 8:00 AM - 5:00 PM
Fr - 8:00 AM - 12:00 PM
Cultural Competency: Y
Ages: 0-99
Hospital Affiliations:
White Mountain Regional Med
Ctr
Cobre Valley Regional Medical
Center
Providence Sacred Heart Med Ctr
& Child
Multicare Deaconess Hospital
Summit Regional Medical Center
Banner Desert Medical Center
Chandler Regional Medical Center
Morales, Ralph E, MD, (M), B
Abdul Memon Md
Provider ID 001184594004
NPI: 1861575573
5882 S Hospital Dr Ste 1
Globe, AZ 85501
(928) 793-3365 E, EB, IB, P, R
Languages Spoken:
Provider: French, Spanish
Ages: 0-99
Hospital Affiliations:
Lafayette General Medical Ctr
Cobre Valley Regional Medical
Center
Lakeland Community Hospital
Watervliet
South Haven Community Hospital
Abbeville General Hospital
Regional Medical Center Of
Acadiana
Lakeland Hospitals
Innovis Health
Morgan, John M, MD, (M), B
Vhs Outpatient Clinics
Provider ID 001949828013
NPI: 1407890353
708 S Coeur D Alene Ln Ste A
Payson, AZ 85541
(928) 472-7440 EB, P, R
Languages Spoken:
Provider: French
Cultural Competency: Y
Ages: 0-99
Hospital Affiliations:
St Lukes Medical Center
Banner Page Hospital
Valleywise Health
Abrazo Arizona Heart Hospital
Banner Univ Medical Cntr
Phoenix Campus
St Josephs Hsp And Med Ctr
Patil, Arun S, MD, (M), B
Integrated Medical Services
Provider ID 000925056009
NPI: 1093955908
111 W Cedar Ln Ste A
Payson, AZ 85541
(623) 433-0202 E, EB, IB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
St Josephs Hsp And Med Ctr
West Valley Hospital Medical
Center
Abrazo West Campus
Banner Estrella Medical Center
Sumar, Riyaz A, MD, (M), B
Integrated Medical Services
Provider ID 002415048012
NPI: 1144212721
111 W Cedar Ln Ste A
Payson, AZ 85541
(602) 433-0202 E, EB, IB, P, R
Languages Spoken:
Provider: Hindi
Ages: 0-99
Hospital Affiliations:
Maryvale Hospital Medical Center
Abrazo Maryvale Campus
St Josephs Hsp And Med Ctr
West Valley Hospital Medical
Center
Abrazo West Campus
Banner Estrella Medical Center
Arizona General Hospital
Arizona - Gila Specialists / Especialistas
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
56
CSAZ.18.999.01.9.017
Vakil, Hiva, MD, (M), B
Integrated Medical Services
Provider ID 002780020007
NPI: 1356480172
111 W Cedar Ln Ste A
Payson, AZ 85541
(623) 433-0202 E, EB, IB, P, R
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
Abrazo Arrowhead Campus
Maryvale Hospital Medical Center
Abrazo Maryvale Campus
Abrazo Scottsdale Campus
Jcl Dv Hospital
Select Specialty Hos-phoenix
Banner Thunderbird Medical
Center
Dermatology / Dermatología
Bottiglione, Richard G, MD, (M),
B
Payson Dermatology
Provider ID 000933418003
NPI: 1083621148
313 S Beeline Hwy
Payson, AZ 85541
(928) 472-7107 EB, P, R
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Abrazo Scottsdale Campus
Jcl Dv Hospital
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Fisler, Rita E, MD, (F), B
Advanced Dermatology Of
Arizona
Provider ID 002674851006
NPI: 1134192859
903 E State Highway 260 Ste 4
Payson, AZ 85541
(602) 264-9044 EB, P, R
Languages Spoken:
Provider: French
Cultural Competency: Y
Ages: 0-99
Hospital Affiliations:
Adventhealth Shawnee Mission
Shawnee Mission Medical Ctr
Jazayeri, Sadra S, MD, (M), B
Metropolitan Dermatology
Provider ID 002291806001
NPI: 1700893864
313 S Beeline Hwy
Payson, AZ 85541
(928) 472-7107 EB, P, R
Languages Spoken:
Provider: French, Persian
Ages: 0-99
Hospital Affiliations:
Paradise Valley Hospital
Abrazo Scottsdale Campus
Banner Del E Webb Medical
Center
Khan, Yulia K, MD, (F), B
Advanced Dermatology Of
Arizona
Provider ID 003321651001
NPI: 1386808368
903 E State Highway 260 Ste 4
Payson, AZ 85541
(602) 264-9044 EB, P, R
Languages Spoken:
Provider: Russian
Cultural Competency: Y
Ages: 0-99
Hospital Affiliations:
Sanford Medical Center
Mchs Fairmont
Yale New Haven Hospital
Sheftel, Scott N, MD, (M), B
Sheftel & Associates Dermatology
Provider ID 001404898001
NPI: 1134128564
5882 S Hospital Dr Ste 3
Globe, AZ 85501
(520) 293-5757 E, EB, IB, P, R
Languages Spoken:
Staff: Spanish
Interpreter: Medical Interp
Vendor
Ages: 14-99
Hospital Affiliations:
Cobre Valley Regional Medical
Center
Copper Queen Community
Hospital
Carondelet St Marys Hospital
Northwest Medical Center
Oro Valley Hospital
Sheftel, Scott N, MD, (M), B
Sheftel & Associates Dermatology
Provider ID 001404898001
NPI: 1134128564
5886 S Hospital Dr
Globe, AZ 85501
(520) 293-5757 EB, P, R
Ages: 14-99
Hospital Affiliations:
Cobre Valley Regional Medical
Center
Copper Queen Community
Hospital
Carondelet St Marys Hospital
Northwest Medical Center
Oro Valley Hospital
Specialists / Especialistas Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
57
CSAZ.18.999.01.9.017
Family Nurse Practitioner /
Enfermera De Familia
Brown, Delana P, FNP, (F)
Statclinix Plc
Provider ID 005336182023
NPI: 1356731418
101 E Hwy 260 Ste G
Payson, AZ 85541
(928) 478-8905 EB, P, R
Languages Spoken:
Staff: Spanish
Ages: 0-99
Bucchireddigari, Lokeswari, FNP,
(F)
Statclinix Plc
Provider ID 005175676006
NPI: 1538575253
101 E Hwy 260 Ste G
Payson, AZ 85541
(928) 478-8905 EB, P, R
Ages: 0-99
Hospital Affiliations:
Honorhealth Scottsdale Shea
Medical Ctr
Scottsdale Healthcare Shea
Medical Ctr
Scttsdle Hlth Shea
Campton, Carley R, NP, (F)
Vhs Outpatient Clinics
Provider ID 006854557002
NPI: 1457844482
708 S Coeur D Alene Ln Ste A
Payson, AZ 85541
(928) 474-7440 EB, P, R
Ages: 0-99
Hospital Affiliations:
Abrazo Arizona Heart Hospital
Christiansen, Sheena A, FNP, (F)
Banner Urgent Care Arizona
Provider ID 005349732003
NPI: 1245662063
101 E State Highway 260 Ste G
Payson, AZ 85541
(928) 478-8905 EB, P, R
Ages: 0-99
Cobbs, Brian W, FNP, (M)
Banner Urgent Care Arizona
Provider ID 006191359004
NPI: 1205381969
101 E State Highway 260 Ste G
Payson, AZ 85541
(928) 478-8905 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Baywood Medical Center
Chandler Regional Medical Center
Corrigan, Teresa A, FNP, (F)
Payson Dermatology
Provider ID 003843412008
NPI: 1386841765
313 S Beeline Hwy
Payson, AZ 85541
(928) 472-7107 EB, P, R
Web address: www.paysondoctors.c
om
Ages: 0-99
Hospital Affiliations:
Banner Payson Medical Center
Davis, Jessica R, FNP, (F)
Banner Urgent Care Arizona
Provider ID 006225512003
NPI: 1619423001
101 E State Highway 260 Ste G
Payson, AZ 85541
(928) 478-8905
Ages: 0-99
Eckhardt, Jody, FNP, (F)
Vhs Outpatient Clinics
Provider ID 005731271001
NPI: 1871650564
708 S Coeur D Alene Ln Ste 1
Payson, AZ 85541
(928) 472-7440 EB, P, R
Ages: 0-99
Ekman, John K, FNP, (M)
Southeastern Arizona Behavioral
Health S
Provider ID 002455301001
NPI: 1194722256
996 N Broad St Ste 10
Globe, AZ 85501
(928) 425-2185 EB, P, R
Ages: 0-99
Hospital Affiliations:
Mt Graham Regional Medical
Cente
Areas of Expertise: Serious Mental
Illness
Engelman, Holly J, FNP, (F)
Banner Urgent Care Arizona
Provider ID 006273925002
NPI: 1346790748
101 E State Highway 260 Ste G
Payson, AZ 85541
(928) 478-8905 EB, P, R
Ages: 0-99
Hutzler, Rachel L, FNP, (F)
Banner Urgent Care Arizona
Provider ID 003690758004
NPI: 1760817050
101 E State Highway 260 Ste G
Payson, AZ 85541
(928) 478-8905 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner University Med Ctr South
Campus
Arizona - Gila Specialists / Especialistas
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
58
CSAZ.18.999.01.9.017
Lindner, Elizabeth J, FNP, (F)
Banner Urgent Care Arizona
Provider ID 005410802003
NPI: 1316343049
101 E State Highway 260 Ste G
Payson, AZ 85541
(928) 478-8905 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner University Med Ctr South
Campus
Miles, Jenny W, FNP, (F)
Banner Urgent Care Arizona
Provider ID 006610557003
NPI: 1487199824
101 E State Highway 260 Ste G
Payson, AZ 85541
(928) 478-8905 EB, P, R
Ages: 0-99
Montano, Gilbert J, FNP, (M)
Banner Urgent Care Arizona
Provider ID 003060396009
NPI: 1821286915
101 E State Highway 260 Ste G
Payson, AZ 85541
(928) 478-8905
Languages Spoken:
Provider: Spanish
Ages: 0-99
Myers, Janet, FNP, (F)
Banner Urgent Care Arizona
Provider ID 003513166010
NPI: 1427316652
101 E State Highway 260 Ste G
Payson, AZ 85541
(928) 478-8905
Ages: 0-99
O'brien, Mary Jane, FNP, (F)
Banner Urgent Care Arizona
Provider ID 006287615003
NPI: 1851842447
101 E State Highway 260 Ste G
Payson, AZ 85541
(928) 478-8905 EB, P, R
Ages: 0-99
Saha, Deepa J, FNP, (F)
Banner Urgent Care Arizona
Provider ID 003602066021
NPI: 1457690752
101 E State Highway 260 Ste G
Payson, AZ 85541
(928) 478-8905 EB, P, R
Languages Spoken:
Provider: Bengali, Hindi
Ages: 0-99
Hospital Affiliations:
Valleywise Health
Banner Univ Medical Cntr
Phoenix Campus
Stover, Linda C, FNP, (F)
Banner Urgent Care Arizona
Provider ID 002000724039
NPI: 1972575975
101 E State Highway 260 Ste G
Payson, AZ 85541
(928) 478-8905 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Casa Grande Regional Med Ctr
Banner Casa Grande Medical
Center
Wickenburg Community Hospital
Toth, Sharon L, FNP, (F)
Banner Urgent Care Arizona
Provider ID 003022061018
NPI: 1982776563
101 E State Highway 260 Ste G
Payson, AZ 85541
(928) 478-8905 EB, P, R
Ages: 0-99
Family Practice / Medicina
Familiar
Merrill, Jarilynne B, MD, (F), B
Statclinix Plc
Provider ID 002124028001
NPI: 1912963943
101 E Hwy 260 Ste G
Payson, AZ 85541
(928) 478-8905 EB, P, R
Ages: 0-99
Parker, Ronald D, MD, (M), B
The Az Partnership For
Immunization
Provider ID 002755614013
NPI: 1285798405
5515 S Apache Ave
Globe, AZ 85501
(928) 425-3189 EB, P, R
Languages Spoken:
Provider: Japanese
Ages: 0-99
Hospital Affiliations:
La Paz Regional Hospital
Havasu Regional Medical Center
Sahani, Mandeep M, MD, (M)
Desert Kidney Associates
Provider ID 002051653001
NPI: 1811080633
5860 S Hospital Dr Ste 103
Globe, AZ 85501
(480) 834-9039 EB, P, R
Languages Spoken:
Provider: Hindi, Punjabi
Specialists / Especialistas Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
59
CSAZ.18.999.01.9.017
Ages: 0-99
Hospital Affiliations:
Mercy Med Ctr-des Moines
Mercyone Des Moines Medical
Center
St Lukes Regional Medical Center
Banner Desert Medical Center
General Surgery / Cirugía
Abdo, Joseph G, MD, (M), B
Joseph G Abdo Md
Provider ID 001189389004
NPI: 1821090879
1100 E Monroe St Ste 102
Globe, AZ 85501
(928) 425-7133 EB, P, R
Languages Spoken:
Provider: Arabic, French,
Lebanese
Ages: 0-99
Hospital Affiliations:
Cobre Valley Regional Medical
Center
Banner Baywood Medical Center
Chandler Regional Medical Center
Mercy Gilbert Medical Center
Banner Gateway Medical Center
Arizona Regional Medical Center
Galitsky, Anthony, MD, (M), B
Cobre Valley Regional Medical
Center
Provider ID 003252499004
NPI: 1952585598
5880 S Hospital Dr
Globe, AZ 85501
(928) 425-3261 EB, P, R
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
St Lukes Medical Center
Lahey Clinic Hospital
Chandler Regional Medical Center
Banner Estrella Medical Center
Horne, Susan C, MD, (F), B
Banner Physician Specialists
Arizona
Provider ID 002959270001
NPI: 1336343763
122 E Main St
Payson, AZ 85541
(928) 472-3478 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Payson Medical Center
Banner Baywood Medical Center
Banner Baywood Heart Hospital
Banner Gateway Medical Center
Ledesma, Linda-Michelle, DO, (F)
Banner Urgent Care Arizona
Provider ID 003810368003
NPI: 1801181581
101 E State Highway 260 Ste G
Payson, AZ 85541
(928) 478-8905 EB, P, R
Ages: 0-99
Munoz, Luis A, MD, (M)
Western Vascular Institute
Provider ID 000285065007
NPI: 1619937232
708 S Coeur D Alene Ln Ste B
Payson, AZ 85541
(480) 668-5000 EB, P, R
Web address: www.paysondoctors.c
om
Ages: 0-99
Hospital Affiliations:
Banner Payson Medical Center
Abrazo Arrowhead Campus
Banner Boswell Medical Center
Banner Baywood Medical Center
Abrazo Arizona Heart Hospital
Banner Univ Medical Cntr
Phoenix Campus
Olson, Loyd B, MD, (M)
Banner Physician Specialists
Arizona
Provider ID 005635256001
NPI: 1306165733
122 E Main St
Payson, AZ 85541
(923) 596-4600 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Payson Medical Center
Arizona - Gila Specialists / Especialistas
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
60
CSAZ.18.999.01.9.017
Sawyer, Steven J, MD, (M), B
Cobre Valley Tonto Basin Clinic
Provider ID 002081462003
NPI: 1598713489
124 N Tewksbury Blvd
Young, AZ 85554
(928) 462-3435 EB, P, R
Ages: 0-99
Hospital Affiliations:
Montrose Memorial Hospital
Cobre Valley Regional Medical
Center
Maryvale Hospital Medical Center
Abrazo Maryvale Campus
Sawyer, Steven J, MD, (M), B
Cobre Valley Tonto Basin Clinic
Provider ID 002081462003
NPI: 1598713489
5880 S Hospital Dr
Globe, AZ 85501
(928) 425-3246 EB, P, R
Ages: 0-99
Hospital Affiliations:
Montrose Memorial Hospital
Cobre Valley Regional Medical
Center
Maryvale Hospital Medical Center
Abrazo Maryvale Campus
Sawyer, Steven J, MD, (M), B
Cobre Valley Tonto Basin Clinic
Provider ID 002081462003
NPI: 1598713489
5994 S Hospital Dr
Globe, AZ 85501
(928) 425-7108 EB, P, R
Ages: 0-99
Hospital Affiliations:
Montrose Memorial Hospital
Cobre Valley Regional Medical
Center
Maryvale Hospital Medical Center
Abrazo Maryvale Campus
Swidinsky, Teddi, MD, (F)
Community Care Partners
Provider ID 006544757001
NPI: 1578090296
1100 N Beeline Hwy Ste A
Payson, AZ 85541
(480) 462-2950 EB, P, R
Ages: 0-99
Hospital Affiliations:
Presbyterian Espanola Hospital
Alta Vista Regional Hospital
Wombold, Leroy D, DO, (M), B
Banner Physician Specialists
Arizona
Provider ID 000465672005
NPI: 1841267937
122 E Main St Ste A
Payson, AZ 85541
(928) 596-4600 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Payson Medical Center
Ellett Memorial Hospital
Providence Mt Carmel Hospital
Golden Valley Memorial Hospital
Hematology / Hematología
Grover, Rajinder S, MD, (M), B
Palo Verde Hematology Oncology
Provider ID 002391909003
NPI: 1376561225
807 S Ponderosa
Payson, AZ 85541
(602) 258-4875 EB, P, R
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
City Of Hope National Med Ctr
Abrazo Arrowhead Campus
Northwestern Memorial Hospital
Honorhealth Scottsdale Shea
Medical Ctr
Scottsdale Healthcare Shea
Medical Ctr
Scttsdle Hlth Shea
Langford, Martin B, MD, (M), B
Palo Verde Hematology Oncology
Provider ID 001068734004
NPI: 1992729826
807 S Ponderosa St
Payson, AZ 85541
(602) 258-4875 E, EB, P, R
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
Abrazo Arrowhead Campus
Abrazo Scottsdale Campus
Banner Thunderbird Medical
Center
Scttsdle Hlth Osb
Honorhealth Scottsdale Shea
Medical Ctr
Scottsdale Healthcare Shea
Medical Ctr
Scttsdle Hlth Shea
Hematology/Oncology /
Hematología/Oncología
Specialists / Especialistas Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
61
CSAZ.18.999.01.9.017
Ahmad, Nazish, DO, (F), B
Palo Verde Hematology Oncology
Provider ID 004220421002
NPI: 1609187921
807 S Ponderosa
Payson, AZ 85541
(602) 258-4875 EB, P, R
Languages Spoken:
Provider: Urdu
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Banner Thunderbird Medical
Center
Abrazo Scottsdale Campus
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Scttsdle Hlth Osb
Honorhealth Scottsdale Shea
Medical Ctr
Scottsdale Healthcare Shea
Medical Ctr
Bi, Sucai, MD, (M), B
Banner Cancer Center Specialists
Provider ID 002313000007
NPI: 1659363794
807 S Ponderosa St
Payson, AZ 85541
(928) 471-3222 EB, P, R
Languages Spoken:
Provider: Chinese
Ages: 0-99
Hospital Affiliations:
Good Samaritan Reg Med Center
Banner Univ Medical Cntr
Phoenix Campus
St Josephs Hsp And Med Ctr
Banner Gateway Medical Center
Grover, Rajinder S, MD, (M)
Palo Verde Hematology Oncology
Provider ID 002391909003
NPI: 1376561225
807 S Ponderosa
Payson, AZ 85541
(602) 258-4875 EB, P, R
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
City Of Hope National Med Ctr
Abrazo Arrowhead Campus
Northwestern Memorial Hospital
Honorhealth Scottsdale Shea
Medical Ctr
Scottsdale Healthcare Shea
Medical Ctr
Scttsdle Hlth Shea
Halepota, Maqbool A, MD, (M), B
Palo Verde Hematology Oncology
Provider ID 001445800004
NPI: 1558384966
807 S Ponderosa St
Payson, AZ 85541
(602) 258-4875 EB, P, R
Languages Spoken:
Provider: Urdu, Sinhalese
Web address: www.pvhomed.com
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Abrazo Scottsdale Campus
Banner Thunderbird Medical
Center
Scttsdle Hlth Osb
Honorhealth Scottsdale Shea
Medical Ctr
Scottsdale Healthcare Shea
Medical Ctr
Scttsdle Hlth Shea
Banner Estrella Medical Center
Rakkar, Amol N, MD, (M), B
Palo Verde Hematology Oncology
Provider ID 001864972002
NPI: 1336160241
807 S Ponderosa St
Payson, AZ 85541
(928) 474-5729 E, EB, P, R
Languages Spoken:
Provider: Punjabi, Hindi, Indian
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Banner Boswell Medical Center
Banner Thunderbird Medical
Center
Scttsdle Hlth Osb
Honorhealth Scottsdale Shea
Medical Ctr
Scottsdale Healthcare Shea
Medical Ctr
Thakkar, Snehal G, MD, (M)
Cobre Valley Tonto Basin Clinic
Provider ID 002817457006
NPI: 1518160241
186 E Stephens Way
Tonto Basin, AZ 85553
(928) 479-2871 EB, P, R
Ages: 0-99
Hospital Affiliations:
Summit Regional Medical Center
Honorhealth Scottsdale Shea
Medical Ctr
Scottsdale Healthcare Shea
Medical Ctr
Scttsdle Hlth Shea
Arizona - Gila Specialists / Especialistas
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
62
CSAZ.18.999.01.9.017
Thakkar, Snehal G, MD, (M)
Cobre Valley Tonto Basin Clinic
Provider ID 002817457006
NPI: 1518160241
5880 S Hospital Dr
Globe, AZ 85501
(928) 425-3261 EB, P, R
Ages: 0-99
Hospital Affiliations:
Summit Regional Medical Center
Honorhealth Scottsdale Shea
Medical Ctr
Scottsdale Healthcare Shea
Medical Ctr
Scttsdle Hlth Shea
Thakkar, Snehal G, MD, (M)
Cobre Valley Tonto Basin Clinic
Provider ID 002817457006
NPI: 1518160241
5994 S Hospital Dr
Globe, AZ 85501
(928) 425-7108 EB, P, R
Ages: 0-99
Hospital Affiliations:
Summit Regional Medical Center
Honorhealth Scottsdale Shea
Medical Ctr
Scottsdale Healthcare Shea
Medical Ctr
Scttsdle Hlth Shea
Hepatology / Hepatología
Ramos, Alberto X, MD, (M)
Banner Uni Med Ctr Phx Campus
Liver Dise
Provider ID 002832986004
NPI: 1487788998
117 E Main St Bldg A100
Payson, AZ 85541
(602) 839-2606 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Banner University Med Ctr South
Campus
University Medical Center
Banner University Med Ctr
Tucson Campus
Banner Univ Medical Cntr
Phoenix Campus
Ramos, Alberto X, MD, (M)
Banner Uni Med Ctr Phx Campus
Liver Dise
Provider ID 002832986004
NPI: 1487788998
708 S Coeur D Alene Ln
Payson, AZ 85541
(602) 239-6324 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Banner University Med Ctr South
Campus
University Medical Center
Banner University Med Ctr
Tucson Campus
Banner Univ Medical Cntr
Phoenix Campus
Internal Medicine / Medicina
Interna
Askari, Ali A, MD, (M), B
Ali A Askari Md
Provider ID 000940356004
NPI: 1760554919
1106 N Beeline Hwy
Payson, AZ 85541
(928) 474-5286 EB, P, R
Languages Spoken:
Provider: Farsi, Persian, Spanish
Ages: 0-99
Hospital Affiliations:
St Lukes Medical Center
Banner Payson Medical Center
Select Specialty Hos-phoenix
Select Specialty Hospital
Banner Univ Medical Cntr
Phoenix Campus
St Josephs Hsp And Med Ctr
Kindred Hospital Arizona Phoenix
Kindred Hospital Az-northwest
Phoenix
Bheemanathini, Praveen, MD,
(M)
Banner Urgent Care Arizona
Provider ID 006103086005
NPI: 1669729042
101 E State Highway 260 Ste G
Payson, AZ 85541
(928) 478-8905
Languages Spoken:
Provider: Hindi, Telugu
Ages: 0-99
Hospital Affiliations:
Casa Grande Regional Med Ctr
Banner Casa Grande Medical
Center
Banner Baywood Medical Center
Banner Baywood Heart Hospital
Banner Gateway Medical Center
Carstens, Sarah J, MD, (F), B
Banner Hospital Ba Phys Az
Provider ID 003191243004
NPI: 1952506867
807 S Ponderosa St
Payson, AZ 85541
(928) 474-3222 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Univ Medical Cntr
Phoenix Campus
Specialists / Especialistas Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
63
CSAZ.18.999.01.9.017
Challa, Suresh, MD, (M), B
Banner Hospital Ba Phys Az
Provider ID 003372067006
NPI: 1578711024
807 S Ponderosa St
Payson, AZ 85541
(928) 474-3222 EB, P, R
Languages Spoken:
Provider: Telugu
Does Not Accept New Patients
Ages: 0-99
Hospital Affiliations:
Banner Baywood Medical Center
Banner Univ Medical Cntr
Phoenix Campus
Banner Estrella Medical Center
Banner Gateway Medical Center
Chase, Robyn N, DO, (F), B
Banner Univ Hosp Based Phys
Provider ID 003191827013
NPI: 1093911760
807 S Ponderosa St
Payson, AZ 85541
(928) 471-3222 E, EB, P, R
Ages: 0-99
Hospital Affiliations:
Casa Grande Regional Med Ctr
Banner Casa Grande Medical
Center
Yavapai Regional Medical Center
West
Banner Univ Medical Cntr
Phoenix Campus
Chaudhary, Asad J, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002919294002
NPI: 1073786794
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Punjabi, Urdu
Ages: 0-99
Hospital Affiliations:
Regional One Health
Regional Medical Ctr At Memphis
Banner Baywood Medical Center
Banner Desert Medical Center
Banner Gateway Medical Center
Chaudhary, Asad J, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002919294002
NPI: 1073786794
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Punjabi, Urdu
Ages: 0-99
Hospital Affiliations:
Regional One Health
Regional Medical Ctr At Memphis
Banner Baywood Medical Center
Banner Desert Medical Center
Banner Gateway Medical Center
Cumbria, Wayne M, MD, (M)
Az Kidney Dis & Hypertension
Provider ID 002352616001
NPI: 1629048046
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: French, Croatian
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Kingman Regional Medical Center
Havasu Regional Medical Center
Abrazo Arizona Heart Hospital
Greenbaum Surgical Speciality
Hospital
Cumbria, Wayne M, MD, (M)
Az Kidney Dis & Hypertension
Provider ID 002352616001
NPI: 1629048046
903 E State Highway 260 Ste 2
Payson, AZ 85541
(928) 649-7997 EB, P, R
Languages Spoken:
Provider: French, Croatian
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Kingman Regional Medical Center
Havasu Regional Medical Center
Abrazo Arizona Heart Hospital
Greenbaum Surgical Speciality
Hospital
Halepota, Maqbool A, MD, (M)
Palo Verde Hematology Oncology
Provider ID 001445800004
NPI: 1558384966
807 S Ponderosa St
Payson, AZ 85541
(602) 258-4875 EB, P, R
Languages Spoken:
Provider: Urdu, Sinhalese
Web address: www.pvhomed.com
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Abrazo Scottsdale Campus
Banner Thunderbird Medical
Center
Scttsdle Hlth Osb
Honorhealth Scottsdale Shea
Medical Ctr
Scottsdale Healthcare Shea
Medical Ctr
Scttsdle Hlth Shea
Banner Estrella Medical Center
Arizona - Gila Specialists / Especialistas
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
64
CSAZ.18.999.01.9.017
Ho, Warren Reyes, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 001977119003
NPI: 1073721965
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Mount Sinai Hospital
Franklin Square Hospital Center
Trinity Hospitals
Ho, Warren Reyes, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 001977119003
NPI: 1073721965
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 566-8646 EB, P, R
Mo-Fr - 8:00 AM - 4:30 PM
Ages: 0-99
Hospital Affiliations:
Mount Sinai Hospital
Franklin Square Hospital Center
Trinity Hospitals
Kulkarni, Sanjay B, MD, (M), B
Banner Hospital Ba Phys Az
Provider ID 002791592010
NPI: 1003923491
807 S Ponderosa St
Payson, AZ 85541
(928) 474-3222 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Thunderbird Medical
Center
Banner Estrella Medical Center
Langford, Martin B, MD, (M)
Palo Verde Hematology Oncology
Provider ID 001068734004
NPI: 1992729826
807 S Ponderosa St
Payson, AZ 85541
(602) 258-4875 E, EB, P, R
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
Abrazo Arrowhead Campus
Abrazo Scottsdale Campus
Banner Thunderbird Medical
Center
Scttsdle Hlth Osb
Honorhealth Scottsdale Shea
Medical Ctr
Scottsdale Healthcare Shea
Medical Ctr
Scttsdle Hlth Shea
Leopold, Peter S, DO, (M)
Az Kidney Dis & Hypertension
Provider ID 002193609004
NPI: 1740283423
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Yavapai Regional Medical Center
West
Abrazo Arrowhead Campus
Banner Boswell Medical Center
Banner Thunderbird Medical
Center
Leopold, Peter S, DO, (M)
Az Kidney Dis & Hypertension
Provider ID 002193609004
NPI: 1740283423
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Yavapai Regional Medical Center
West
Abrazo Arrowhead Campus
Banner Boswell Medical Center
Banner Thunderbird Medical
Center
Marupakula, Vidyasagargoud,
MD, (M), B
Banner Hospital Ba Phys Az
Provider ID 003653799004
NPI: 1003123530
807 S Ponderosa St
Payson, AZ 85541
(928) 474-3222 EB, P, R
Languages Spoken:
Provider: Hindi, Telugu
Ages: 0-99
Hospital Affiliations:
Casa Grande Regional Med Ctr
Banner Casa Grande Medical
Center
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Banner Baywood Medical Center
Banner Gateway Medical Center
Specialists / Especialistas Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
65
CSAZ.18.999.01.9.017
Memon, Abdul Q, MD, (M), B
Abdul Memon Md
Provider ID 001870839013
NPI: 1093781346
5882 S Hospital Dr Ste 1
Globe, AZ 85501
(480) 748-4238 E, EB, IB, P, R
Languages Spoken:
Provider: Hindi, Spanish, Urdu
Mo-Th - 8:00 AM - 5:00 PM
Fr - 8:00 AM - 12:00 PM
Cultural Competency: Y
Ages: 0-99
Hospital Affiliations:
White Mountain Regional Med
Ctr
Cobre Valley Regional Medical
Center
Providence Sacred Heart Med Ctr
& Child
Multicare Deaconess Hospital
Summit Regional Medical Center
Banner Desert Medical Center
Chandler Regional Medical Center
Nasim, Kashif, MD, (M), B
Banner Hospital Ba Phys Az
Provider ID 003096219009
NPI: 1144467135
807 S Ponderosa St
Payson, AZ 85541
(928) 474-3222 EB, P, R
Languages Spoken:
Provider: Hindi
Ages: 0-99
Hospital Affiliations:
Banner Baywood Medical Center
Banner Gateway Medical Center
Ngo-Truong, Lisa L, MD, (F), B
Banner Hospital Ba Phys Az
Provider ID 003516020009
NPI: 1700013687
807 S Ponderosa St
Payson, AZ 85541
(928) 474-3222 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Univ Medical Cntr
Phoenix Campus
Banner Estrella Medical Center
Banner Gateway Medical Center
Banner Ironwood Medical Center
Nguyen, Dat D, MD, (M), B
The Az Partnership For
Immunization
Provider ID 002623514006
NPI: 1982698528
5515 S Apache Ave
Globe, AZ 85501
(928) 425-3189 EB, P, R
Languages Spoken:
Provider: Vietnamese
Does Not Accept New Patients
Ages: 0-99
Hospital Affiliations:
Kingman Regional Medical Center
Pyles, Ryan M, DO, (M), B
Banner Hospital Ba Phys Az
Provider ID 003368380010
NPI: 1750549093
807 S Ponderosa St
Payson, AZ 85541
(928) 474-3222 EB, P, R
Ages: 18-99
Hospital Affiliations:
Banner Gateway Medical Center
Banner Ironwood Medical Center
Ramos, Alberto X, MD, (M)
Banner Uni Med Ctr Phx Campus
Liver Dise
Provider ID 002832986004
NPI: 1487788998
117 E Main St Bldg A100
Payson, AZ 85541
(602) 839-2606 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Banner University Med Ctr South
Campus
University Medical Center
Banner University Med Ctr
Tucson Campus
Banner Univ Medical Cntr
Phoenix Campus
Ramos, Alberto X, MD, (M)
Banner Uni Med Ctr Phx Campus
Liver Dise
Provider ID 002832986004
NPI: 1487788998
708 S Coeur D Alene Ln
Payson, AZ 85541
(602) 239-6324 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Banner University Med Ctr South
Campus
University Medical Center
Banner University Med Ctr
Tucson Campus
Banner Univ Medical Cntr
Phoenix Campus
Arizona - Gila Specialists / Especialistas
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
66
CSAZ.18.999.01.9.017
Raskin, David A, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 000920042001
NPI: 1457354003
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Banner Thunderbird Medical
Center
Abrazo Scottsdale Campus
Jcl Dv Hospital
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Banner Boswell Medical Center
Banner Univ Medical Cntr
Phoenix Campus
Raskin, David A, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 000920042001
NPI: 1457354003
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Banner Thunderbird Medical
Center
Abrazo Scottsdale Campus
Jcl Dv Hospital
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Banner Boswell Medical Center
Banner Univ Medical Cntr
Phoenix Campus
Saadat, Sharareh, MD, (F), B
Az Kidney Dis & Hypertension
Provider ID 003427068004
NPI: 1609036268
903 E State Highway 260 Ste 2
Payson, AZ 85541
(928) 649-7997 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Thunderbird Medical
Center
Banner Boswell Medical Center
West Valley Hospital Medical
Center
Abrazo West Campus
Banner Estrella Medical Center
Shuja, Khawaja F, MD, (F), B
Banner Hospital Ba Phys Az
Provider ID 002816411005
NPI: 1801091467
807 S Ponderosa St
Payson, AZ 85541
(928) 474-3222 EB, P, R
Languages Spoken:
Provider: Urdu
Ages: 0-99
Hospital Affiliations:
Banner Baywood Medical Center
Banner Estrella Medical Center
Banner Gateway Medical Center
Sikuyayenga, Mutende J, MD,
(M), B
Banner Hospital Ba Phys Az
Provider ID 003651652008
NPI: 1528387347
807 S Ponderosa St
Payson, AZ 85541
(928) 474-3222 EB, P, R
Languages Spoken:
Provider: French, Swahili
Ages: 18-99
Hospital Affiliations:
Banner Baywood Medical Center
Banner Univ Medical Cntr
Phoenix Campus
Banner Estrella Medical Center
Banner Gateway Medical Center
Banner Goldfield Medical Center
Interventional Cardiology /
Cardiología Intervencionista
Klein, Neal A, MD, (M), B
Vhs Outpatient Clinics
Provider ID 000062010021
NPI: 1639111743
708 S Coeur D Alene Ln Ste A
Payson, AZ 85541
(928) 472-7440 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
St Lukes Medical Center
Banner Page Hospital
Valleywise Health
Abrazo Arizona Heart Hospital
Banner Univ Medical Cntr
Phoenix Campus
St Josephs Hsp And Med Ctr
Oasis Hospital
Loli, Akil I, MD, (M), B
Vhs Outpatient Clinics
Provider ID 002302374017
NPI: 1962453803
708 S Coeur D Alene Ln Ste A
Payson, AZ 85541
(928) 472-7440 EB, P, R
Languages Spoken:
Provider: Albanian (Tosk),
Italian, Spanish
Specialists / Especialistas Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
67
CSAZ.18.999.01.9.017
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
Casa Grande Regional Med Ctr
Banner Casa Grande Medical
Center
Valleywise Health
Banner Univ Medical Cntr
Phoenix Campus
St Josephs Hsp And Med Ctr
Maki, Peter C, MD, (M), B
Vhs Outpatient Clinics
Provider ID 000623695008
NPI: 1306886775
708 S Coeur D Alene Ln Ste 1
Payson, AZ 85541
(928) 472-7440 EB, P, R
Languages Spoken:
Provider: Spanish
Cultural Competency: Y
Ages: 0-99
Hospital Affiliations:
St Lukes Medical Center
Banner Page Hospital
Valleywise Health
Abrazo Arizona Heart Hospital
Select Specialty Hospital Western
Mo
Banner Univ Medical Cntr
Phoenix Campus
Scttsdle Hlth Osb
Honorhealth Scottsdale Shea
Medical Ctr
Memon, Abdul Q, MD, (M)
Abdul Memon Md
Provider ID 001870839013
NPI: 1093781346
5882 S Hospital Dr Ste 1
Globe, AZ 85501
(480) 748-4238 E, EB, IB, P, R
Languages Spoken:
Provider: Hindi, Spanish, Urdu
Mo-Th - 8:00 AM - 5:00 PM
Fr - 8:00 AM - 12:00 PM
Cultural Competency: Y
Ages: 0-99
Hospital Affiliations:
White Mountain Regional Med
Ctr
Cobre Valley Regional Medical
Center
Providence Sacred Heart Med Ctr
& Child
Multicare Deaconess Hospital
Summit Regional Medical Center
Banner Desert Medical Center
Chandler Regional Medical Center
Sumar, Riyaz A, MD, (M), B
Integrated Medical Services
Provider ID 002415048012
NPI: 1144212721
111 W Cedar Ln Ste A
Payson, AZ 85541
(602) 433-0202 E, EB, IB, P, R
Languages Spoken:
Provider: Hindi
Ages: 0-99
Hospital Affiliations:
Maryvale Hospital Medical Center
Abrazo Maryvale Campus
St Josephs Hsp And Med Ctr
West Valley Hospital Medical
Center
Abrazo West Campus
Banner Estrella Medical Center
Arizona General Hospital
Nephrology / Nefrología
Aslam, Kaleem, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 003616805002
NPI: 1578727509
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Urdu
Ages: 0-99
Hospital Affiliations:
Kingman Regional Medical Center
Western Arizona Regional
Medical
Havasu Regional Medical Center
Banner Thunderbird Medical
Center
Valley View Medical Center
Aslam, Kaleem, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 003616805002
NPI: 1578727509
903 E State Highway 260 Ste 2
Payson, AZ 85541
(928) 649-7997 EB, P, R
Languages Spoken:
Provider: Urdu
Ages: 0-99
Hospital Affiliations:
Kingman Regional Medical Center
Western Arizona Regional
Medical
Havasu Regional Medical Center
Banner Thunderbird Medical
Center
Valley View Medical Center
Arizona - Gila Specialists / Especialistas
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
68
CSAZ.18.999.01.9.017
Atalla, Jamal, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002424548002
NPI: 1609861566
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Arabic
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
Abrazo Arrowhead Campus
Maryvale Hospital Medical Center
Abrazo Maryvale Campus
Banner Boswell Medical Center
Abrazo Arizona Heart Hospital
Banner Univ Medical Cntr
Phoenix Campus
St Josephs Hsp And Med Ctr
Balakrishnan, Radhakrishnan B,
MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002033402001
NPI: 1851377139
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Gujarati, Hindi, Tamil
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Abrazo Scottsdale Campus
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Abrazo Arizona Heart Hospital
Banner Thunderbird Medical
Center
Banner Univ Medical Cntr
Phoenix Campus
Banner Estrella Medical Center
Bechtold, Lance L, MD, (M)
Az Kidney Dis & Hypertension
Provider ID 007067471001
NPI: 1336554070
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Havasu Regional Medical Center
Belen, Cary D, DO, (M), B
Az Kidney Dis & Hypertension
Provider ID 003463209001
NPI: 1982885323
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner University Med Ctr South
Campus
Banner Univ Medical Cntr
Phoenix Campus
Kindred Hospital Tucson
Belen, Cary D, DO, (M), B
Az Kidney Dis & Hypertension
Provider ID 003463209001
NPI: 1982885323
903 E State Highway 260 Ste 2
Payson, AZ 85541
(928) 649-7997 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner University Med Ctr South
Campus
Banner Univ Medical Cntr
Phoenix Campus
Kindred Hospital Tucson
Bibb, Javier M, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002771555002
NPI: 1871513358
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Banner Thunderbird Medical
Center
Banner Boswell Medical Center
Scttsdle Hlth Osb
Honorhealth Scottsdale Shea
Medical Ctr
Scottsdale Healthcare Shea
Medical Ctr
Scttsdle Hlth Shea
Promise Hospital Of Phoenix
Bibb, Javier M, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002771555002
NPI: 1871513358
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Spanish
Specialists / Especialistas Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
69
CSAZ.18.999.01.9.017
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Banner Thunderbird Medical
Center
Banner Boswell Medical Center
Scttsdle Hlth Osb
Honorhealth Scottsdale Shea
Medical Ctr
Scottsdale Healthcare Shea
Medical Ctr
Scttsdle Hlth Shea
Promise Hospital Of Phoenix
Bista, Amar B, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002054862001
NPI: 1740266923
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Bengali, Hindi, Nepali
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Banner Thunderbird Medical
Center
Abrazo Scottsdale Campus
Jcl Dv Hospital
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Abrazo Arizona Heart Hospital
Bista, Amar B, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002054862001
NPI: 1740266923
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Bengali, Hindi, Nepali
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Banner Thunderbird Medical
Center
Abrazo Scottsdale Campus
Jcl Dv Hospital
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Abrazo Arizona Heart Hospital
Bueno, Damaso S, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 001991186001
NPI: 1336143759
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Filipino, Spanish
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
West Valley Hospital Medical
Center
Abrazo West Campus
Banner Estrella Medical Center
Burstein, David M, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 001169891002
NPI: 1861462707
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
Abrazo Arrowhead Campus
Banner Thunderbird Medical
Center
Abrazo Arizona Heart Hospital
Scttsdle Hlth Osb
Honorhealth Scottsdale Shea
Medical Ctr
Scottsdale Healthcare Shea
Medical Ctr
Scttsdle Hlth Shea
Burstein, David M, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 001169891002
NPI: 1861462707
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
Abrazo Arrowhead Campus
Banner Thunderbird Medical
Center
Abrazo Arizona Heart Hospital
Scttsdle Hlth Osb
Honorhealth Scottsdale Shea
Medical Ctr
Scottsdale Healthcare Shea
Medical Ctr
Scttsdle Hlth Shea
Arizona - Gila Specialists / Especialistas
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
70
CSAZ.18.999.01.9.017
Buxton-Fattohy, Suzan S, MD,
(F), B
Az Kidney Dis & Hypertension
Provider ID 003024310002
NPI: 1386861235
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Arabic
Mo-Fr - 8:00 AM - 4:30 PM
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Carondelet St Marys Hospital
Mosaic Medical Center Albany
Northwest Medical Center
Banner Boswell Medical Center
Abrazo Arizona Heart Hospital
Oro Valley Hospital
Banner Estrella Medical Center
Chalasani, Rajendra, MD, (M)
Az Kidney Dis & Hypertension
Provider ID 002851410003
NPI: 1437349677
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Hindi
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
Abrazo Arrowhead Campus
Abrazo Scottsdale Campus
Jcl Dv Hospital
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Chalasani, Rajendra, MD, (M)
Az Kidney Dis & Hypertension
Provider ID 002851410003
NPI: 1437349677
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Hindi
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
Abrazo Arrowhead Campus
Abrazo Scottsdale Campus
Jcl Dv Hospital
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Channis, Basel, MD, (M), B
Banner Hospital Ba Phys Az
Provider ID 003496703009
NPI: 1982834594
807 S Ponderosa St
Payson, AZ 85541
(928) 474-3222 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Univ Medical Cntr
Phoenix Campus
Banner Estrella Medical Center
Banner Gateway Medical Center
Chaudhary, Asad J, MD, (M)
Az Kidney Dis & Hypertension
Provider ID 002919294002
NPI: 1073786794
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Punjabi, Urdu
Ages: 0-99
Hospital Affiliations:
Regional One Health
Regional Medical Ctr At Memphis
Banner Baywood Medical Center
Banner Desert Medical Center
Banner Gateway Medical Center
Chaudhary, Asad J, MD, (M)
Az Kidney Dis & Hypertension
Provider ID 002919294002
NPI: 1073786794
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Punjabi, Urdu
Ages: 0-99
Hospital Affiliations:
Regional One Health
Regional Medical Ctr At Memphis
Banner Baywood Medical Center
Banner Desert Medical Center
Banner Gateway Medical Center
Specialists / Especialistas Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
71
CSAZ.18.999.01.9.017
Chen, Ang, MD, (F), B
Az Kidney Dis & Hypertension
Provider ID 002475283002
NPI: 1497852404
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Carondelet St Marys Hospital
Northwest Medical Center
Flagstaff Medical Center
Chen, Ang, MD, (F), B
Az Kidney Dis & Hypertension
Provider ID 002475283002
NPI: 1497852404
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Carondelet St Marys Hospital
Northwest Medical Center
Flagstaff Medical Center
Chugh, Tarun, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 003591091001
NPI: 1568695203
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Punjabi
Ages: 0-99
Hospital Affiliations:
Banner Baywood Heart Hospital
Banner Desert Medical Center
Chandler Regional Medical Center
Mercy Gilbert Medical Center
Mountain Vista Medical Ctr
Banner Gateway Medical Center
Chugh, Tarun, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 003591091001
NPI: 1568695203
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Punjabi
Ages: 0-99
Hospital Affiliations:
Banner Baywood Heart Hospital
Banner Desert Medical Center
Chandler Regional Medical Center
Mercy Gilbert Medical Center
Mountain Vista Medical Ctr
Banner Gateway Medical Center
Cortez, Andrew J, DO, (M), B
Az Kidney Dis & Hypertension
Provider ID 002592134001
NPI: 1902882806
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Valleywise Health
Select Specialty Hos-phoenix
Scttsdle Hlth Osb
St Josephs Hsp And Med Ctr
Banner Estrella Medical Center
Cortez, Andrew J, DO, (M), B
Az Kidney Dis & Hypertension
Provider ID 002592134001
NPI: 1902882806
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Valleywise Health
Select Specialty Hos-phoenix
Scttsdle Hlth Osb
St Josephs Hsp And Med Ctr
Banner Estrella Medical Center
Cumbria, Wayne M, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002352616001
NPI: 1629048046
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: French, Croatian
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Kingman Regional Medical Center
Havasu Regional Medical Center
Abrazo Arizona Heart Hospital
Greenbaum Surgical Speciality
Hospital
Arizona - Gila Specialists / Especialistas
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
72
CSAZ.18.999.01.9.017
Cumbria, Wayne M, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002352616001
NPI: 1629048046
903 E State Highway 260 Ste 2
Payson, AZ 85541
(928) 649-7997 EB, P, R
Languages Spoken:
Provider: French, Croatian
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Kingman Regional Medical Center
Havasu Regional Medical Center
Abrazo Arizona Heart Hospital
Greenbaum Surgical Speciality
Hospital
Dahl, Katharine C, MD, (F), B
Az Kidney Dis & Hypertension
Provider ID 002771544001
NPI: 1073559621
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
Abrazo Arrowhead Campus
Abrazo Arizona Heart Hospital
Banner Univ Medical Cntr
Phoenix Campus
Phx Childrens Hospital
St Josephs Hsp And Med Ctr
Dahl, Katharine C, MD, (F), B
Az Kidney Dis & Hypertension
Provider ID 002771544001
NPI: 1073559621
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
Abrazo Arrowhead Campus
Abrazo Arizona Heart Hospital
Banner Univ Medical Cntr
Phoenix Campus
Phx Childrens Hospital
St Josephs Hsp And Med Ctr
De Long, Michael J, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002659632004
NPI: 1912928201
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Carondelet St Marys Hospital
University Medical Center
Banner University Med Ctr
Tucson Campus
Northwest Medical Center
Cedars Sinai Medical Center
Aventura Hospital & Medical Ctr
Oro Valley Hospital
Desai, Sachin N, MD, (M)
Az Kidney Dis & Hypertension
Provider ID 002760803001
NPI: 1194761742
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Gujarati, Guarani
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
Abrazo Arrowhead Campus
Banner Thunderbird Medical
Center
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Banner Univ Medical Cntr
Phoenix Campus
Desai, Sachin N, MD, (M)
Az Kidney Dis & Hypertension
Provider ID 002760803001
NPI: 1194761742
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Gujarati, Guarani
Specialists / Especialistas Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
73
CSAZ.18.999.01.9.017
Mo-Fr - 8:00 AM - 4:30 PM
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
Abrazo Arrowhead Campus
Banner Thunderbird Medical
Center
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Banner Univ Medical Cntr
Phoenix Campus
Dixon, Megan B, MD, (F), B
Az Kidney Dis & Hypertension
Provider ID 002921546002
NPI: 1689868416
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
Mercy Hospital
United Hospital
Mercy Hospital Unity Campus
North Memorial Health Hospital
Abrazo Arrowhead Campus
Carondelet St Marys Hospital
Healtheast St Johns Hospital
Dixon, Megan B, MD, (F), B
Az Kidney Dis & Hypertension
Provider ID 002921546002
NPI: 1689868416
903 E State Highway 260 Ste 2
Payson, AZ 85541
(928) 649-7997 EB, P, R
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
Mercy Hospital
United Hospital
Mercy Hospital Unity Campus
North Memorial Health Hospital
Abrazo Arrowhead Campus
Carondelet St Marys Hospital
Healtheast St Johns Hospital
Fadia, Amit J, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002014406002
NPI: 1316984339
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Gujarati
Ages: 0-99
Hospital Affiliations:
Banner University Med Ctr South
Campus
Carondelet St Marys Hospital
University Medical Center
Banner University Med Ctr
Tucson Campus
Northwest Medical Center
Banner Baywood Medical Center
Banner Baywood Heart Hospital
Banner Univ Medical Cntr
Phoenix Campus
Gatchalian, Raul A, MD, (M), B
Desert Kidney Associates
Provider ID 002800636001
NPI: 1114029584
5860 S Hospital Dr Ste 102
Globe, AZ 85501
(480) 834-9039 E, EB, G, IB, P,
PL, R, T
Languages Spoken:
Provider: Tagalog
Ages: 0-99
Hospital Affiliations:
Banner Baywood Medical Center
Gila River Healthcare
Gatchalian, Raul A, MD, (M), B
Desert Kidney Associates
Provider ID 002800636001
NPI: 1114029584
5860 S Hospital Dr Ste 103
Globe, AZ 85501
(480) 834-9039 EB, P, R
Languages Spoken:
Provider: Tagalog
Ages: 0-99
Hospital Affiliations:
Banner Baywood Medical Center
Gila River Healthcare
Goswami, Puja, MD, (F), B
Az Kidney Dis & Hypertension
Provider ID 003720997003
NPI: 1912168857
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Spanish
Arizona - Gila Specialists / Especialistas
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
74
CSAZ.18.999.01.9.017
Ages: 0-99
Hospital Affiliations:
Casa Grande Regional Med Ctr
Banner Casa Grande Medical
Center
Jcl Dv Hospital
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Banner Baywood Medical Center
Banner Thunderbird Medical
Center
Ronald Reagan Ucla Medical
Center
Goswami, Puja, MD, (F), B
Az Kidney Dis & Hypertension
Provider ID 003720997003
NPI: 1912168857
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Casa Grande Regional Med Ctr
Banner Casa Grande Medical
Center
Jcl Dv Hospital
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Banner Baywood Medical Center
Banner Thunderbird Medical
Center
Ronald Reagan Ucla Medical
Center
Hachem, Hassan A, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002434501001
NPI: 1598768020
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Spanish, French
Ages: 0-99
Hospital Affiliations:
Kingman Regional Medical Center
Western Arizona Regional
Medical
Banner Boswell Medical Center
Banner Baywood Medical Center
Banner Baywood Heart Hospital
Banner Desert Medical Center
Banner Desert Care Center
Chandler Regional Medical Center
Hachem, Hassan A, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002434501001
NPI: 1598768020
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Spanish, French
Ages: 0-99
Hospital Affiliations:
Kingman Regional Medical Center
Western Arizona Regional
Medical
Banner Boswell Medical Center
Banner Baywood Medical Center
Banner Baywood Heart Hospital
Banner Desert Medical Center
Banner Desert Care Center
Chandler Regional Medical Center
Hanna, Abboud, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 003057401007
NPI: 1922237072
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Baptist Medical Center
Abrazo Central Campus
St Rose Dominican Hosp Delima
Campus
Sunrise Hospital & Med Ctr
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Select Specialty Hospital
Banner Estrella Medical Center
Hanna, Abboud, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 003057401007
NPI: 1922237072
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Staff: Arabic
Mo-Fr - 8:00 AM - 4:30 PM
Ages: 0-99
Hospital Affiliations:
Baptist Medical Center
Abrazo Central Campus
St Rose Dominican Hosp Delima
Campus
Sunrise Hospital & Med Ctr
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Select Specialty Hospital
Banner Estrella Medical Center
Specialists / Especialistas Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
75
CSAZ.18.999.01.9.017
Ho, Warren Reyes, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 001977119003
NPI: 1073721965
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Mount Sinai Hospital
Franklin Square Hospital Center
Trinity Hospitals
Ho, Warren Reyes, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 001977119003
NPI: 1073721965
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 566-8646 EB, P, R
Mo-Fr - 8:00 AM - 4:30 PM
Ages: 0-99
Hospital Affiliations:
Mount Sinai Hospital
Franklin Square Hospital Center
Trinity Hospitals
Howlader, Anjuman A, MD, (F)
Az Kidney Dis & Hypertension
Provider ID 002983134004
NPI: 1467600833
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Bengali
Ages: 0-99
Hospital Affiliations:
Banner University Med Ctr South
Campus
Fort Sanders Regional Medical Ctr
University Medical Center
Banner University Med Ctr
Tucson Campus
Northwest Medical Center
Tennova Health
Tennova Healthcare
Blount Memorial Hospital
Kartoumah, Almutaz B, MD, (M)
Az Kidney Dis & Hypertension
Provider ID 002801892001
NPI: 1376654293
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Arabic
Web address: www.akdhc.net
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Kingman Regional Medical Center
Western Arizona Regional
Medical
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Banner Baywood Medical Center
West Valley Hospital Medical
Center
Abrazo West Campus
Kartoumah, Almutaz B, MD, (M)
Az Kidney Dis & Hypertension
Provider ID 002801892001
NPI: 1376654293
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Arabic
Web address: www.akdhc.net
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Kingman Regional Medical Center
Western Arizona Regional
Medical
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Banner Baywood Medical Center
West Valley Hospital Medical
Center
Abrazo West Campus
Kim, Jin K, MD, (F), B
Az Kidney Dis & Hypertension
Provider ID 002077615008
NPI: 1467503920
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Yavapai Regional Medical Center
West
Verde Valley Medical Cntr
Kingman Regional Medical Center
Western Arizona Regional
Medical
Havasu Regional Medical Center
Arizona - Gila Specialists / Especialistas
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
76
CSAZ.18.999.01.9.017
Krieble, Barry F, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 001078544001
NPI: 1740287218
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
St Joseph's Hospital
Indiana University Health
Franciscan Health Indianapolis
Krieble, Barry F, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 001078544001
NPI: 1740287218
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
St Joseph's Hospital
Indiana University Health
Franciscan Health Indianapolis
Laurel, Edgardo R, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 001102566001
NPI: 1992708788
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Filipino
Ages: 0-99
Hospital Affiliations:
Maryvale Hospital Medical Center
Abrazo Maryvale Campus
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Banner Boswell Medical Center
Abrazo Arizona Heart Hospital
Banner Univ Medical Cntr
Phoenix Campus
Banner Desert Medical Center
Laurel, Edgardo R, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 001102566001
NPI: 1992708788
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Filipino
Ages: 0-99
Hospital Affiliations:
Maryvale Hospital Medical Center
Abrazo Maryvale Campus
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Banner Boswell Medical Center
Abrazo Arizona Heart Hospital
Banner Univ Medical Cntr
Phoenix Campus
Banner Desert Medical Center
Leopold, Peter S, DO, (M), B
Az Kidney Dis & Hypertension
Provider ID 002193609004
NPI: 1740283423
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Yavapai Regional Medical Center
West
Abrazo Arrowhead Campus
Banner Boswell Medical Center
Banner Thunderbird Medical
Center
Leopold, Peter S, DO, (M), B
Az Kidney Dis & Hypertension
Provider ID 002193609004
NPI: 1740283423
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Yavapai Regional Medical Center
West
Abrazo Arrowhead Campus
Banner Boswell Medical Center
Banner Thunderbird Medical
Center
Lien, Yeong-Hau H, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 001037762001
NPI: 1356448815
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Chinese
Specialists / Especialistas Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
77
CSAZ.18.999.01.9.017
Ages: 0-99
Hospital Affiliations:
Banner University Med Ctr South
Campus
Tucson Medical Center
University Medical Center
Banner University Med Ctr
Tucson Campus
Northwest Medical Center
Lien, Yeong-Hau H, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 001037762001
NPI: 1356448815
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Chinese
Ages: 0-99
Hospital Affiliations:
Banner University Med Ctr South
Campus
Tucson Medical Center
University Medical Center
Banner University Med Ctr
Tucson Campus
Northwest Medical Center
Liu, Zhao, MD, (F), B
Az Kidney Dis & Hypertension
Provider ID 002852129001
NPI: 1942356365
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Mandarin
Ages: 0-99
Hospital Affiliations:
St Peters University Hospital
Kingman Regional Medical Center
Robert Wood Johnson Univ Hosp
Liu, Zhao, MD, (F), B
Az Kidney Dis & Hypertension
Provider ID 002852129001
NPI: 1942356365
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Mandarin
Ages: 0-99
Hospital Affiliations:
St Peters University Hospital
Kingman Regional Medical Center
Robert Wood Johnson Univ Hosp
Logan, Joy L, MD, (F)
Az Kidney Dis & Hypertension
Provider ID 001887591005
NPI: 1285732859
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Portuguese, Spanish
Ages: 0-99
Hospital Affiliations:
Banner University Med Ctr South
Campus
Carondelet St Marys Hospital
University Medical Center
Banner University Med Ctr
Tucson Campus
Logan, Joy L, MD, (F)
Az Kidney Dis & Hypertension
Provider ID 001887591005
NPI: 1285732859
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Portuguese, Spanish
Ages: 0-99
Hospital Affiliations:
Banner University Med Ctr South
Campus
Carondelet St Marys Hospital
University Medical Center
Banner University Med Ctr
Tucson Campus
Mishler, Rick E, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 000746416004
NPI: 1629071303
903 E State Highway 260 Ste 2
Payson, AZ 85541
(928) 857-2381 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
Abrazo Arrowhead Campus
University Medical Center
Banner University Med Ctr
Tucson Campus
Western Arizona Regional
Medical
Jcl Dv Hospital
Banner Boswell Medical Center
Banner Univ Medical Cntr
Phoenix Campus
Morales, Alejandro, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002483829003
NPI: 1134192909
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: German, Portuguese,
Spanish
Arizona - Gila Specialists / Especialistas
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
78
CSAZ.18.999.01.9.017
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Banner Thunderbird Medical
Center
Banner Univ Medical Cntr
Phoenix Campus
Scttsdle Hlth Osb
Honorhealth Scottsdale Shea
Medical Ctr
Scottsdale Healthcare Shea
Medical Ctr
Scttsdle Hlth Shea
Morales, Alejandro, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002483829003
NPI: 1134192909
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: German, Portuguese,
Spanish
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Banner Thunderbird Medical
Center
Banner Univ Medical Cntr
Phoenix Campus
Scttsdle Hlth Osb
Honorhealth Scottsdale Shea
Medical Ctr
Scottsdale Healthcare Shea
Medical Ctr
Scttsdle Hlth Shea
Mumick, Guneet K, MD, (F), B
Az Kidney Dis & Hypertension
Provider ID 002792919001
NPI: 1376657338
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Hindi
Ages: 0-99
Hospital Affiliations:
Banner University Med Ctr South
Campus
Abrazo Arrowhead Campus
Banner Thunderbird Medical
Center
Jcl Dv Hospital
Banner Boswell Medical Center
Select Specialty Hos-phoenix
Mustafa, Esmat M, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002897099004
NPI: 1033307574
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Arabic
Ages: 0-99
Hospital Affiliations:
Casa Grande Regional Med Ctr
Banner Casa Grande Medical
Center
Abrazo Arrowhead Campus
Banner Thunderbird Medical
Center
Maryvale Hospital Medical Center
Abrazo Maryvale Campus
Banner Del E Webb Medical
Center
Honorhealth Scottsdale Shea
Medical Ctr
Mustafa, Esmat M, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002897099004
NPI: 1033307574
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Arabic
Ages: 0-99
Hospital Affiliations:
Casa Grande Regional Med Ctr
Banner Casa Grande Medical
Center
Abrazo Arrowhead Campus
Banner Thunderbird Medical
Center
Maryvale Hospital Medical Center
Abrazo Maryvale Campus
Banner Del E Webb Medical
Center
Honorhealth Scottsdale Shea
Medical Ctr
Nabha, Anil, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002932114002
NPI: 1558547562
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Spanish
Specialists / Especialistas Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
79
CSAZ.18.999.01.9.017
Ages: 0-99
Hospital Affiliations:
Banner University Med Ctr South
Campus
St Joseph's Hospital
Carondelet St Marys Hospital
University Medical Center
Banner University Med Ctr
Tucson Campus
Cornerstone Hospital Of Se
Arizona
Cornerstone Specialty Hospitals
Tucson
Nabha, Anil, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002932114002
NPI: 1558547562
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Banner University Med Ctr South
Campus
St Joseph's Hospital
Carondelet St Marys Hospital
University Medical Center
Banner University Med Ctr
Tucson Campus
Cornerstone Hospital Of Se
Arizona
Cornerstone Specialty Hospitals
Tucson
Neumann, Thomas V, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 000839728003
NPI: 1316041916
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Yavapai Regional Medical Center
West
Verde Valley Medical Cntr
Neumann, Thomas V, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 000839728002
NPI: 1316041916
903 E State Highway 260 Ste 2
Payson, AZ 85541
(928) 649-7997 EB, P, R
Ages: 0-99
Hospital Affiliations:
Yavapai Regional Medical Center
West
Verde Valley Medical Cntr
Neyra, Nilda R, MD, (F), B
Az Kidney Dis & Hypertension
Provider ID 001779825003
NPI: 1235132895
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: French, Spanish
Ages: 0-99
Hospital Affiliations:
Maryvale Hospital Medical Center
Abrazo Maryvale Campus
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Banner Univ Medical Cntr
Phoenix Campus
St Josephs Hsp And Med Ctr
Nica, Romanita D, MD, (F), B
Az Kidney Dis & Hypertension
Provider ID 002756399001
NPI: 1366486144
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Romanian
Ages: 0-99
Hospital Affiliations:
Yavapai Regional Medical Center
West
Verde Valley Medical Cntr
Abrazo Scottsdale Campus
Banner Univ Medical Cntr
Phoenix Campus
Nica, Romanita D, MD, (F), B
Az Kidney Dis & Hypertension
Provider ID 002756399001
NPI: 1366486144
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Romanian
Arizona - Gila Specialists / Especialistas
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
80
CSAZ.18.999.01.9.017
Ages: 0-99
Hospital Affiliations:
Yavapai Regional Medical Center
West
Verde Valley Medical Cntr
Abrazo Scottsdale Campus
Banner Univ Medical Cntr
Phoenix Campus
Packer, Jeffrey, DO, (M), B
Az Kidney Dis & Hypertension
Provider ID 000084798002
NPI: 1578566139
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: German
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
Abrazo Scottsdale Campus
Banner Boswell Medical Center
Banner Univ Medical Cntr
Phoenix Campus
St Josephs Hsp And Med Ctr
Parekh, Shehzad M, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002274862001
NPI: 1023027307
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Urdu
Ages: 0-99
Hospital Affiliations:
Kingman Regional Medical Center
Western Arizona Regional
Medical
Havasu Regional Medical Center
Valley View Medical Center
Parekh, Shehzad M, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002274862001
NPI: 1023027307
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Urdu
Ages: 0-99
Hospital Affiliations:
Kingman Regional Medical Center
Western Arizona Regional
Medical
Havasu Regional Medical Center
Valley View Medical Center
Perveze, Zeeshan, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002813134001
NPI: 1851591895
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Urdu
Ages: 0-99
Hospital Affiliations:
Banner University Med Ctr South
Campus
St Joseph's Hospital
Tucson Medical Center
Sierra Vista Regional Health Ctr
Canyon Vista Medical Center
University Medical Center
Banner University Med Ctr
Tucson Campus
Northwest Medical Center
Perveze, Zeeshan, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002813134001
NPI: 1851591895
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Urdu
Ages: 0-99
Hospital Affiliations:
Banner University Med Ctr South
Campus
St Joseph's Hospital
Tucson Medical Center
Sierra Vista Regional Health Ctr
Canyon Vista Medical Center
University Medical Center
Banner University Med Ctr
Tucson Campus
Northwest Medical Center
Pokharel, Milap, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 003463011004
NPI: 1336349463
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Nepali
Ages: 0-99
Hospital Affiliations:
Banner University Med Ctr South
Campus
Tucson Medical Center
University Medical Center
Banner University Med Ctr
Tucson Campus
Northwest Medical Center
Specialists / Especialistas Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
81
CSAZ.18.999.01.9.017
Pokharel, Milap, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 003463011004
NPI: 1336349463
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Nepali
Staff: Spanish
Mo-Fr - 8:00 AM - 4:30 PM
Ages: 0-99
Hospital Affiliations:
Banner University Med Ctr South
Campus
Tucson Medical Center
University Medical Center
Banner University Med Ctr
Tucson Campus
Northwest Medical Center
Raskin, David A, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 000920042001
NPI: 1457354003
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Banner Thunderbird Medical
Center
Abrazo Scottsdale Campus
Jcl Dv Hospital
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Banner Boswell Medical Center
Banner Univ Medical Cntr
Phoenix Campus
Raskin, David A, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 000920042001
NPI: 1457354003
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Banner Thunderbird Medical
Center
Abrazo Scottsdale Campus
Jcl Dv Hospital
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Banner Boswell Medical Center
Banner Univ Medical Cntr
Phoenix Campus
Reyes, Carlos, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 003460666002
NPI: 1831212117
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Banner University Med Ctr South
Campus
Tucson Medical Center
Sierra Vista Regional Health Ctr
Canyon Vista Medical Center
Northwest Medical Center
Oro Valley Hospital
Kindred Hospital Tucson
Green Valley Hospital
Reyes, Carlos, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 003460666002
NPI: 1831212117
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Spanish
Mo-Th - 8:00 AM - 4:30 PM
Fr - 8:00 AM - 4:00 PM
Ages: 0-99
Hospital Affiliations:
Banner University Med Ctr South
Campus
Tucson Medical Center
Sierra Vista Regional Health Ctr
Canyon Vista Medical Center
Northwest Medical Center
Oro Valley Hospital
Kindred Hospital Tucson
Green Valley Hospital
Rivero, Alejandro J, MD, (M)
Az Kidney Dis & Hypertension
Provider ID 000395735002
NPI: 1861419509
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Carondelet St Marys Hospital
Northwest Medical Center
Oro Valley Hospital
Arizona - Gila Specialists / Especialistas
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
82
CSAZ.18.999.01.9.017
Rivero, Alejandro J, MD, (M)
Az Kidney Dis & Hypertension
Provider ID 000395735002
NPI: 1861419509
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Carondelet St Marys Hospital
Northwest Medical Center
Oro Valley Hospital
Robey, Jean T, MD, (F), B
Az Kidney Dis & Hypertension
Provider ID 002752551001
NPI: 1255377800
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Vietnamese
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Abrazo Arizona Heart Hospital
Scttsdle Hlth Osb
Banner Estrella Medical Center
Kindred Hospital Az-northwest
Phoenix
Robey, Jean T, MD, (F), B
Az Kidney Dis & Hypertension
Provider ID 002752551001
NPI: 1255377800
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Vietnamese
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Abrazo Arizona Heart Hospital
Scttsdle Hlth Osb
Banner Estrella Medical Center
Kindred Hospital Az-northwest
Phoenix
Rokkam, Vamsi, MD, (M)
Az Kidney Dis & Hypertension
Provider ID 002808635001
NPI: 1174738389
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
Abrazo Arrowhead Campus
Medical Center At Bowling Green
Maryvale Hospital Medical Center
Abrazo Maryvale Campus
Abrazo Scottsdale Campus
Jcl Dv Hospital
Honorhealth John C Lincoln
Medical Ctr
Rokkam, Vamsi, MD, (M)
Az Kidney Dis & Hypertension
Provider ID 002808635001
NPI: 1174738389
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
Abrazo Arrowhead Campus
Medical Center At Bowling Green
Maryvale Hospital Medical Center
Abrazo Maryvale Campus
Abrazo Scottsdale Campus
Jcl Dv Hospital
Honorhealth John C Lincoln
Medical Ctr
Saadat, Sharareh, MD, (F), B
Az Kidney Dis & Hypertension
Provider ID 003427068005
NPI: 1609036268
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Thunderbird Medical
Center
Banner Boswell Medical Center
West Valley Hospital Medical
Center
Abrazo West Campus
Banner Estrella Medical Center
Specialists / Especialistas Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
83
CSAZ.18.999.01.9.017
Saadat, Sharareh, MD, (F), B
Az Kidney Dis & Hypertension
Provider ID 003427068004
NPI: 1609036268
903 E State Highway 260 Ste 2
Payson, AZ 85541
(928) 649-7997 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Thunderbird Medical
Center
Banner Boswell Medical Center
West Valley Hospital Medical
Center
Abrazo West Campus
Banner Estrella Medical Center
Sacks, Paul, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 000746418001
NPI: 1255334892
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Abrazo Scottsdale Campus
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Banner Boswell Medical Center
Banner Univ Medical Cntr
Phoenix Campus
Banner Estrella Medical Center
Sacks, Paul, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 000746418001
NPI: 1255334892
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Abrazo Scottsdale Campus
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Banner Boswell Medical Center
Banner Univ Medical Cntr
Phoenix Campus
Banner Estrella Medical Center
Sahani, Mandeep M, MD, (M), B
Desert Kidney Associates
Provider ID 002051653001
NPI: 1811080633
5860 S Hospital Dr Ste 103
Globe, AZ 85501
(480) 834-9039 EB, P, R
Languages Spoken:
Provider: Hindi, Punjabi
Ages: 0-99
Hospital Affiliations:
Mercy Med Ctr-des Moines
Mercyone Des Moines Medical
Center
St Lukes Regional Medical Center
Banner Desert Medical Center
Salehi-Rad, Reza, DO, (M), B
Az Kidney Dis & Hypertension
Provider ID 003188454001
NPI: 1649460593
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Havasu Regional Medical Center
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Banner Thunderbird Medical
Center
West Valley Hospital Medical
Center
Abrazo West Campus
Banner Estrella Medical Center
Salehi-Rad, Reza, DO, (M), B
Az Kidney Dis & Hypertension
Provider ID 003188454001
NPI: 1649460593
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Havasu Regional Medical Center
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Banner Thunderbird Medical
Center
West Valley Hospital Medical
Center
Abrazo West Campus
Banner Estrella Medical Center
Arizona - Gila Specialists / Especialistas
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
84
CSAZ.18.999.01.9.017
Sanna, Sathish, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 005612811016
NPI: 1215168059
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Casa Grande Regional Med Ctr
Banner Casa Grande Medical
Center
Banner Boswell Medical Center
Gila River Healthcare
Banner Baywood Heart Hospital
Banner Desert Medical Center
Banner Desert Care Center
Chandler Regional Medical Center
Sanna, Sathish, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 005612811016
NPI: 1215168059
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Casa Grande Regional Med Ctr
Banner Casa Grande Medical
Center
Banner Boswell Medical Center
Gila River Healthcare
Banner Baywood Heart Hospital
Banner Desert Medical Center
Banner Desert Care Center
Chandler Regional Medical Center
Santos, Peter W, DO, (M), B
Az Kidney Dis & Hypertension
Provider ID 002799711002
NPI: 1932249612
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Tagalog
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
Abrazo Arrowhead Campus
Abrazo Arizona Heart Hospital
Banner Thunderbird Medical
Center
Santos, Peter W, DO, (M), B
Az Kidney Dis & Hypertension
Provider ID 002799711002
NPI: 1932249612
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Tagalog
Mo-Fr - 8:00 AM - 4:30 PM
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
Abrazo Arrowhead Campus
Abrazo Arizona Heart Hospital
Banner Thunderbird Medical
Center
Shakil, Bassam S, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 004515288001
NPI: 1790915684
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Urdu
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Kingman Regional Medical Center
Havasu Regional Medical Center
Banner Boswell Medical Center
Shakil, Bassam S, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 004515288001
NPI: 1790915684
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Urdu
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Kingman Regional Medical Center
Havasu Regional Medical Center
Banner Boswell Medical Center
Singh, Harnath, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 001931669002
NPI: 1538133236
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Hindi
Ages: 0-99
Hospital Affiliations:
Little Colorado Medical Center
Summit Regional Medical Center
Verde Valley Medical Cntr
Flagstaff Medical Center
Specialists / Especialistas Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
85
CSAZ.18.999.01.9.017
Singh, Harnath, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 001931669002
NPI: 1538133236
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Hindi
Ages: 0-99
Hospital Affiliations:
Little Colorado Medical Center
Summit Regional Medical Center
Verde Valley Medical Cntr
Flagstaff Medical Center
Swaminathan, Ariv, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 001277884001
NPI: 1699778225
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Abrazo Scottsdale Campus
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Select Specialty Hospital
Banner Thunderbird Medical
Center
St Josephs Hsp And Med Ctr
Swaminathan, Ariv, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 001277884001
NPI: 1699778225
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Abrazo Scottsdale Campus
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Select Specialty Hospital
Banner Thunderbird Medical
Center
St Josephs Hsp And Med Ctr
Ting, Steven C, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002777196002
NPI: 1740388578
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Abrazo Arizona Heart Hospital
Banner Univ Medical Cntr
Phoenix Campus
West Valley Hospital Medical
Center
Abrazo West Campus
Banner Estrella Medical Center
Ting, Steven C, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002777196002
NPI: 1740388578
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Abrazo Arizona Heart Hospital
Banner Univ Medical Cntr
Phoenix Campus
West Valley Hospital Medical
Center
Abrazo West Campus
Banner Estrella Medical Center
Uddin, Muhammad A, MD, (M),
B
Az Kidney Dis & Hypertension
Provider ID 002195413003
NPI: 1396936373
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Hindi, Punjabi, Urdu,
Spanish
Ages: 0-99
Hospital Affiliations:
Banner Baywood Medical Center
Tempe St Lukes Hosp A Campus
Of St Lukes
Banner Desert Medical Center
Chandler Regional Medical Center
Mercy Gilbert Medical Center
Mountain Vista Medical Ctr
Arizona - Gila Specialists / Especialistas
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
86
CSAZ.18.999.01.9.017
Uddin, Muhammad A, MD, (M),
B
Az Kidney Dis & Hypertension
Provider ID 002195413003
NPI: 1396936373
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Hindi, Punjabi, Urdu,
Spanish
Mo-Fr - 8:00 AM - 4:30 PM
Ages: 0-99
Hospital Affiliations:
Banner Baywood Medical Center
Tempe St Lukes Hosp A Campus
Of St Lukes
Banner Desert Medical Center
Chandler Regional Medical Center
Mercy Gilbert Medical Center
Mountain Vista Medical Ctr
Ungar, Scott A, DO, (M), B
Az Kidney Dis & Hypertension
Provider ID 003338019003
NPI: 1306075924
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
Banner Boswell Medical Center
Banner Baywood Medical Center
Banner Baywood Heart Hospital
Banner Univ Medical Cntr
Phoenix Campus
Banner Desert Care Center
Banner Gateway Medical Center
Arizona Regional Medical Center
Ungar, Scott A, DO, (M), B
Az Kidney Dis & Hypertension
Provider ID 003338019003
NPI: 1306075924
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
Banner Boswell Medical Center
Banner Baywood Medical Center
Banner Baywood Heart Hospital
Banner Univ Medical Cntr
Phoenix Campus
Banner Desert Care Center
Banner Gateway Medical Center
Arizona Regional Medical Center
Wang, Shouwen, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002404350003
NPI: 1700889326
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Chinese
Ages: 0-99
Hospital Affiliations:
St Lukes Medical Center
Good Samaritan Hospital Med Ctr
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Abrazo Arizona Heart Hospital
Banner Univ Medical Cntr
Phoenix Campus
St Josephs Hsp And Med Ctr
Kindred Hospital Az-northwest
Phoenix
Wang, Shouwen, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002404350003
NPI: 1700889326
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Chinese
Ages: 0-99
Hospital Affiliations:
St Lukes Medical Center
Good Samaritan Hospital Med Ctr
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Abrazo Arizona Heart Hospital
Banner Univ Medical Cntr
Phoenix Campus
St Josephs Hsp And Med Ctr
Kindred Hospital Az-northwest
Phoenix
Whittman, David T, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002194646001
NPI: 1205938917
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner University Med Ctr South
Campus
University Medical Center
Banner University Med Ctr
Tucson Campus
Specialists / Especialistas Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
87
CSAZ.18.999.01.9.017
Zaharia, Valentin, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002282204002
NPI: 1467455089
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Romanian, Spanish
Ages: 0-99
Hospital Affiliations:
St Lukes Medical Center
North Central Bronx Hospital
Abrazo Arrowhead Campus
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Tempe St Lukes Hosp A Campus
Of St Lukes
Arkansas Heart Hospital
Abrazo Arizona Heart Hospital
Zaharia, Valentin, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002282204002
NPI: 1467455089
903 E State Highway 260 Ste 2
Payson, AZ 85541
(928) 649-7997 EB, P, R
Languages Spoken:
Provider: Romanian, Spanish
Ages: 0-99
Hospital Affiliations:
St Lukes Medical Center
North Central Bronx Hospital
Abrazo Arrowhead Campus
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Tempe St Lukes Hosp A Campus
Of St Lukes
Arkansas Heart Hospital
Abrazo Arizona Heart Hospital
Zar, Tausif, MD, (M)
Az Kidney Dis & Hypertension
Provider ID 002994757001
NPI: 1396889358
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
University Medical Center
Banner University Med Ctr
Tucson Campus
Northwest Medical Center
Oro Valley Hospital
Zar, Tausif, MD, (M)
Az Kidney Dis & Hypertension
Provider ID 002994757001
NPI: 1396889358
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Hospital Affiliations:
University Medical Center
Banner University Med Ctr
Tucson Campus
Northwest Medical Center
Oro Valley Hospital
Zhao, Hui J, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002827657001
NPI: 1629125414
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Chinese
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Banner Thunderbird Medical
Center
Havasu Regional Medical Center
Scttsdle Hlth Osb
Greenbaum Surgical Speciality
Hospital
Scttsdle Hlth Tpk
Scottsdale Healthcare Tho
Zhao, Hui J, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 002827657001
NPI: 1629125414
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Chinese
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Banner Thunderbird Medical
Center
Havasu Regional Medical Center
Scttsdle Hlth Osb
Greenbaum Surgical Speciality
Hospital
Scttsdle Hlth Tpk
Scottsdale Healthcare Tho
Zhao, Joseph, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 004515320001
NPI: 1558545087
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Mandarin, Tagalog
Arizona - Gila Specialists / Especialistas
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
88
CSAZ.18.999.01.9.017
Ages: 0-99
Hospital Affiliations:
Tempe St Lukes Hosp A Campus
Of St Lukes
Banner Baywood Heart Hospital
Banner Desert Medical Center
Chandler Regional Medical Center
Banner Gateway Medical Center
Banner Ironwood Medical Center
Banner Goldfield Medical Center
Zhao, Joseph, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 004515320001
NPI: 1558545087
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Mandarin, Tagalog
Ages: 0-99
Hospital Affiliations:
Tempe St Lukes Hosp A Campus
Of St Lukes
Banner Baywood Heart Hospital
Banner Desert Medical Center
Chandler Regional Medical Center
Banner Gateway Medical Center
Banner Ironwood Medical Center
Banner Goldfield Medical Center
Zou, Lixian, MD, (F), B
Az Kidney Dis & Hypertension
Provider ID 002513853002
NPI: 1053359737
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Spanish, Chinese
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
Abrazo Arrowhead Campus
Abrazo Scottsdale Campus
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Banner Boswell Medical Center
Zou, Lixian, MD, (F), B
Az Kidney Dis & Hypertension
Provider ID 002513853002
NPI: 1053359737
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Spanish, Chinese
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
Abrazo Arrowhead Campus
Abrazo Scottsdale Campus
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Banner Boswell Medical Center
Neurology / Neurología
Badhwar, Shruti, DO, (F)
Phoenix Neurology & Sleep
Medicine
Provider ID 003407383002
NPI: 1497918502
806 S Ponderosa St
Payson, AZ 85541
(623) 535-0050 EB, P, R
Languages Spoken:
Provider: Hindi
Ages: 0-99
Hospital Affiliations:
St Joseph's Hospital
Jcl Dv Hospital
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Capampangan, Dan J, MD, (M),
B
University Physician Specialists
LLC
Provider ID 003343813007
NPI: 1114956273
807 S Ponderosa St
Payson, AZ 85541
(928) 474-3222 EB, P, R
Languages Spoken:
Provider: Tagalog
Ages: 0-99
Hospital Affiliations:
Banner University Med Ctr South
Campus
Casa Grande Regional Med Ctr
Banner Casa Grande Medical
Center
Banner Page Hospital
Mayo Clinic Hospital
Banner Univ Medical Cntr
Phoenix Campus
Banner Desert Medical Center
Banner Ironwood Medical Center
Specialists / Especialistas Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
89
CSAZ.18.999.01.9.017
Lee-Iannotti, Joyce K, MD, (F), B
University Physician Specialists
LLC
Provider ID 003190529009
NPI: 1518133271
807 S Ponderosa St
Payson, AZ 85541
(928) 474-3222 EB, P, R
Ages: 0-99
Hospital Affiliations:
Metrohealth Medical Center
Casa Grande Regional Med Ctr
Banner Casa Grande Medical
Center
Banner Thunderbird Medical
Center
Mayo Clinic Hospital
Banner Univ Medical Cntr
Phoenix Campus
Payne, Jeremy R, MD, (M), B
University Physician Specialists
LLC
Provider ID 002672244004
NPI: 1699727784
807 S Ponderosa St
Payson, AZ 85541
(928) 474-3222 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Univ Medical Cntr
Phoenix Campus
Banner Ironwood Medical Center
Banner Goldfield Medical Center
Torzala, Daniel T, MD, (M), B
Phoenix Neurology & Sleep
Medicine
Provider ID 003037358003
NPI: 1437127990
806 S Ponderosa St
Payson, AZ 85541
(623) 535-0050 EB, P, R
Mo-Th - 8:00 AM - 5:00 PM
Fr - 8:00 AM - 1:00 PM
Ages: 0-99
Hospital Affiliations:
West Valley Hospital Medical
Center
Abrazo West Campus
Banner Estrella Medical Center
Yancy, Holly M, DO, (F), B
University Physician Specialists
LLC
Provider ID 003633525006
NPI: 1861658858
807 S Ponderosa St
Payson, AZ 85541
(928) 474-3222 EB, P, R
Ages: 0-99
Hospital Affiliations:
Casa Grande Regional Med Ctr
Banner Casa Grande Medical
Center
Mayo Clinic Hospital
Banner Ironwood Medical Center
Banner Goldfield Medical Center
Nurse Practitioner / Enfermera
Especialista
Ali, Sheiba, NP, (F)
Hospitalists Of Arizona
Provider ID 006882582004
NPI: 1851871743
1100 E Monroe St
Globe, AZ 85501
(928) 425-5721 EB, IB, P, PL, R
Ages: 0-99
Arias, Sylvia K, NP, (F)
Az Kidney Dis & Hypertension
Provider ID 006789611001
NPI: 1861994824
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Arias, Sylvia K, NP, (F)
Az Kidney Dis & Hypertension
Provider ID 006789611001
NPI: 1861994824
903 E Hwy 260 Ste 2
Payson, AZ 85541
(928) 649-7997 EB, P, R
Languages Spoken:
Provider: Spanish
Mo-Fr - 8:00 AM - 4:30 PM
Ages: 0-99
Arias, Sylvia K, NP, (F)
Az Kidney Dis & Hypertension
Provider ID 006789611001
NPI: 1861994824
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Arizona - Gila Specialists / Especialistas
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
90
CSAZ.18.999.01.9.017
Bingham, Ryan D, MS, (M)
Southwest Behavioral Services
Provider ID 003675579001
NPI: 1316371586
404 W Aero Dr
Payson, AZ 85541
(928) 474-3303 EB, P, R
Languages Spoken:
Provider: Spanish
Web address: www.sbhservices.org
Ages: 0-99
Areas of Expertise: Telemental
Health Capability
De Retana, Natalija, NP, (F)
Abdul Memon Md
Provider ID 006703562001
NPI: 1447768130
5882 S Hospital Dr Ste 1
Globe, AZ 85501
(928) 793-3365 E, EB, IB, P, R
Ages: 0-99
Edelman, Steven R, FNP, (M)
Desert Pain & Rehab Specialists
Provider ID 003051427001
NPI: 1871732727
621 S Fifth St
Globe, AZ 85501
(928) 425-8273 E, EB, IB, P, R
Ages: 18-99
Griffin, Brandie D, FNP, (F)
Cobre Valley Regional Medical
Center
Provider ID 003702457007
NPI: 1093148991
186 E Stephens Way
Tonto Basin, AZ 85553
(928) 479-2871 EB, P, R
Ages: 0-99
Jose, Emily, NP, (F)
Banner Urgent Care Arizona
Provider ID 003610513053
NPI: 1043559438
101 E State Highway 260 Ste G
Payson, AZ 85541
(928) 478-8905 EB, P, R
Ages: 0-99
Klug, Ronald G, NP, (M)
Az Kidney Dis & Hypertension
Provider ID 006179019001
NPI: 1679026017
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Klug, Ronald G, NP, (M)
Az Kidney Dis & Hypertension
Provider ID 006179019001
NPI: 1679026017
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Lindner, Elizabeth J, FNP, (F)
Banner Urgent Care Arizona
Provider ID 005410802003
NPI: 1316343049
101 E State Highway 260 Ste G
Payson, AZ 85541
(928) 478-8905 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner University Med Ctr South
Campus
Mcelroy, Crystal L, FNP, (F)
Banner Urgent Care Arizona
Provider ID 003840312011
NPI: 1659676351
101 E State Highway 260 Ste G
Payson, AZ 85541
(928) 478-8905
Ages: 0-99
Millbourn, Lorna J, NP, (F)
Banner Urgent Care Arizona
Provider ID 003682321011
NPI: 1952740789
101 E State Highway 260 Ste G
Payson, AZ 85541
(928) 478-8905 EB, P, R
Ages: 0-99
Hospital Affiliations:
Gerald Champion Reg Med Ctr
Montano, Gilbert J, FNP, (M)
Banner Urgent Care Arizona
Provider ID 003060396009
NPI: 1821286915
101 E State Highway 260 Ste G
Payson, AZ 85541
(928) 478-8905
Languages Spoken:
Provider: Spanish
Ages: 0-99
Morse, Suzanne, NP, (F)
Northern Arizona Pain Svcs
Provider ID 002748654002
NPI: 1386750511
708 S Coeur D Alene Ln Ste C
Payson, AZ 85541
(928) 474-2234 EB, P, R
Mo-Th - 8:00 AM - 5:00 PM
Fr - 8:00 AM - 12:00 PM
Ages: 0-99
Specialists / Especialistas Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
91
CSAZ.18.999.01.9.017
Robb, Wendy A, NP, (F)
Banner Urgent Care Arizona
Provider ID 006604243041
NPI: 1316324080
101 E State Highway 260 Ste G
Payson, AZ 85541
(928) 478-8905 EB, P, R
Ages: 0-99
Sullivan, Rachel, NP, (F)
Az Kidney Dis & Hypertension
Provider ID 006321494002
NPI: 1801257761
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Ages: 0-99
Zak, Svetlana V, MS, (F)
Mountain Health And Wellness
Provider ID 003182856033
NPI: 1386831832
2250 Hwy 60 Ste I
Globe, AZ 85501
(928) 402-8032 EB, P, R
Languages Spoken:
Provider: Russian
Ages: 0-99
Oncology / Oncología
Bi, Sucai, MD, (M), B
Banner Cancer Center Specialists
Provider ID 002313000007
NPI: 1659363794
807 S Ponderosa St
Payson, AZ 85541
(928) 471-3222 EB, P, R
Languages Spoken:
Provider: Chinese
Ages: 0-99
Hospital Affiliations:
Good Samaritan Reg Med Center
Banner Univ Medical Cntr
Phoenix Campus
St Josephs Hsp And Med Ctr
Banner Gateway Medical Center
Chadha, Manpreet K, MD, (F), B
Palo Verde Hematology Oncology
Provider ID 002962894006
NPI: 1760632442
807 S Ponderosa St
Payson, AZ 85541
(602) 258-4875 EB, P, R
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Banner Thunderbird Medical
Center
Roswell Park Cancer Institute
Abrazo Scottsdale Campus
Banner Boswell Medical Center
Scttsdle Hlth Osb
Honorhealth Scottsdale Shea
Medical Ctr
Scottsdale Healthcare Shea
Medical Ctr
Langford, Martin B, MD, (M), B
Palo Verde Hematology Oncology
Provider ID 001068734004
NPI: 1992729826
807 S Ponderosa St
Payson, AZ 85541
(602) 258-4875 E, EB, P, R
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
Abrazo Arrowhead Campus
Abrazo Scottsdale Campus
Banner Thunderbird Medical
Center
Scttsdle Hlth Osb
Honorhealth Scottsdale Shea
Medical Ctr
Scottsdale Healthcare Shea
Medical Ctr
Scttsdle Hlth Shea
Rakkar, Amol N, MD, (M), B
Palo Verde Hematology Oncology
Provider ID 001864972002
NPI: 1336160241
807 S Ponderosa St
Payson, AZ 85541
(928) 474-5729 E, EB, P, R
Languages Spoken:
Provider: Punjabi, Hindi, Indian
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Banner Boswell Medical Center
Banner Thunderbird Medical
Center
Scttsdle Hlth Osb
Honorhealth Scottsdale Shea
Medical Ctr
Scottsdale Healthcare Shea
Medical Ctr
Arizona - Gila Specialists / Especialistas
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
92
CSAZ.18.999.01.9.017
Ophthalmology / Oftalmología
Bakall, Benjamin B, MD, (M), B
Associated Retina Consultants
Provider ID 003382160004
NPI: 1700085222
302 W Main St
Payson, AZ 85541
(602) 242-4928 EB, P, R
Languages Spoken:
Provider: Swedish
Ages: 0-99
Hospital Affiliations:
Banner Baywood Medical Center
U Of I Hosps & Clinics
U Of Iowa Hosp And Clinic
Maricopa Medical Center
Banner Desert Medical Center
Banner Estrella Medical Center
Banner Gateway Medical Center
Barakat, Mark R, MD, (M), B
Retinal Consultants/Arizona
Provider ID 002940822003
NPI: 1225214646
302 W Main St
Payson, AZ 85541
(888) 831-7898 EB, P, R
Languages Spoken:
Provider: German, Spanish
Web address: www.retinalconsultan
tsaz.com
Ages: 0-99
Hospital Affiliations:
Yuma Regional Medical Center
Cleveland Clinic Foundation
Barakat, Mark R, MD, (M), B
Retinal Consultants/Arizona
Provider ID 002940822003
NPI: 1225214646
5860 S Hospital Dr Ste 101
Globe, AZ 85501
(480) 388-3280 EB, P, R
Languages Spoken:
Provider: German, Spanish
Web address: www.retinalconsultan
tsaz.com
Ages: 0-99
Hospital Affiliations:
Yuma Regional Medical Center
Cleveland Clinic Foundation
Berbos, Zachary J, MD, (M), B
Visage Aesthetics & Plastic
Surgery
Provider ID 003427078001
NPI: 1497996433
520 S Hill St
Globe, AZ 85501
(928) 425-8989 EB, P, R
Ages: 0-99
Hospital Affiliations:
Select Specialty Hospital
Scttsdle Hlth Osb
Bryan, Joseph S, MD, (M), B
Associated Retina Consultants
Provider ID 001320935005
NPI: 1881686558
302 W Main St
Payson, AZ 85541
(602) 242-4928 EB, P, R
Languages Spoken:
Provider: French, Spanish
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Banner Boswell Medical Center
Queens Medical Center
Valleywise Health
Banner Univ Medical Cntr
Phoenix Campus
Banner Desert Medical Center
Desouza, Stephen A, MD, (M), B
Associated Retina Consultants
Provider ID 002199436003
NPI: 1548232820
302 W Main St
Payson, AZ 85541
(602) 242-4928 EB, P, R
Languages Spoken:
Provider: French
Ages: 0-99
Hospital Affiliations:
Valleywise Health
Scttsdle Hlth Osb
Phx Childrens Hospital
St Josephs Hsp And Med Ctr
Mercy Gilbert Medical Center
Goldenberg, David T, MD, (M), B
Retinal Consultants/Arizona
Provider ID 002902280001
NPI: 1417170432
302 W Main St
Payson, AZ 85541
(888) 831-7989 EB, P, R
Languages Spoken:
Provider: Spanish
Specialists / Especialistas Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
93
CSAZ.18.999.01.9.017
Ages: 0-99
Hospital Affiliations:
William Beaumont Hospital-royal
Oak
Banner Thunderbird Medical
Center
Banner Boswell Medical Center
Banner Baywood Medical Center
Banner Desert Medical Center
Scttsdle Hlth Osb
Banner Gateway Medical Center
Goldenberg, David T, MD, (M), B
Retinal Consultants/Arizona
Provider ID 002902280001
NPI: 1417170432
5860 S Hospital Dr Ste 101
Globe, AZ 85501
(480) 388-3280 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
William Beaumont Hospital-royal
Oak
Banner Thunderbird Medical
Center
Banner Boswell Medical Center
Banner Baywood Medical Center
Banner Desert Medical Center
Scttsdle Hlth Osb
Banner Gateway Medical Center
Gordon, Alan J, MD, (M), B
Associated Retina Consultants
Provider ID 001013539006
NPI: 1518959287
302 W Main St
Payson, AZ 85541
(602) 242-4928 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Valleywise Health
Banner Desert Medical Center
St Josephs Hsp And Med Ctr
Klein-Mascia, Kendra A, MD, (F),
B
Associated Retina Consultants
Provider ID 006110128002
NPI: 1205192697
302 W Main St
Payson, AZ 85541
(602) 242-4928 EB, P, R
Ages: 0-99
Hospital Affiliations:
Desert Regional Medical Center -
Compreh
Kwong, Henry M, MD, (M), B
Associated Retina Consultants
Provider ID 002784073006
NPI: 1033257746
302 W Main St
Payson, AZ 85541
(602) 242-4928 EB, P, R
Languages Spoken:
Provider: French
Staff: Spanish
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
Banner Estrella Medical Center
Reddy, Rahul K, MD, (M), B
Associated Retina Consultants
Provider ID 003060704012
NPI: 1083806863
302 W Main St
Payson, AZ 85541
(602) 242-4928 EB, P, R
Languages Spoken:
Provider: Telugu
Ages: 0-99
Hospital Affiliations:
Valleywise Health
Vanderbilt University Med Ctr
Vanderbilt University Medical
Center
Vanderbilt Childrens Hospital
Risser, Christian F, MD, (M), B
Risser Thomas Eye Clinic
Provider ID 000284891001
NPI: 1457482630
302 W Main St
Payson, AZ 85541
(928) 474-4126 EB, P, R
Languages Spoken:
Staff: Spanish
Mo-Fr - 8:00 AM - 4:30 PM
Ages: 0-99
Hospital Affiliations:
Banner Payson Medical Center
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Arizona - Gila Specialists / Especialistas
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
94
CSAZ.18.999.01.9.017
Sangave, Amit A, MD, (M), B
Barnet Dulaney Perkins Eye Ctr
Provider ID 006614024006
NPI: 1447516133
520 S Hill St
Globe, AZ 85501
(928) 425-8989 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Thunderbird Medical
Center
Henry Ford Hospital
Banner Desert Medical Center
Banner Gateway Medical Center
Thomas, Robert A, MD, (M), B
Risser Thomas Eye Clinic
Provider ID 001366200001
NPI: 1134250343
302 W Main St
Payson, AZ 85541
(928) 474-4126 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Banner Payson Medical Center
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
St Josephs Hsp And Med Ctr
Welch, Matthew J, MD, (M), B
Associated Retina Consultants
Provider ID 003357151006
NPI: 1316100977
302 W Main St
Payson, AZ 85541
(602) 242-4928 EB, P, R
Web address: www.associatedretina
consultants.com
Ages: 0-99
Hospital Affiliations:
Loyola University Medical Center
Maricopa Medical Center
Ziemianski, Matthew C, MD, (M),
B
Associated Retina Consultants
Provider ID 000130578004
NPI: 1730169764
302 W Main St
Payson, AZ 85541
(602) 242-4928 EB, P, R
Ages: 0-99
Hospital Affiliations:
Abrazo Central Campus
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Banner Baywood Medical Center
Banner Thunderbird Medical
Center
Banner Univ Medical Cntr
Phoenix Campus
Orthopaedic Surgery / Cirugía
Ortopédica
Benoit, Martin J, MD, (M), B
Banner Physician Specialists
Arizona
Provider ID 002115527001
NPI: 1669429320
126 E Main St Ste D
Payson, AZ 85541
(928) 596-4800 EB, P, R
Languages Spoken:
Provider: French
Ages: 0-99
Hospital Affiliations:
Eh Sm Hospital Detroit Lakes
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Biehn, Jeffrey L, DO, (M)
Banner Physician Specialists
Arizona
Provider ID 003501763001
NPI: 1669637062
126 E Main St Ste D
Payson, AZ 85541
(928) 596-4800 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Ironwood Medical Center
Banner Goldfield Medical Center
Croft, Scott T, MD, (M), B
Cobre Valley Tonto Basin Clinic
Provider ID 001342682004
NPI: 1619934163
124 N Tewksbury Blvd
Young, AZ 85554
(928) 462-3435 EB, P, R
Languages Spoken:
Provider: Japanese
Specialists / Especialistas Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
95
CSAZ.18.999.01.9.017
Ages: 0-99
Hospital Affiliations:
Frances Mahon Deaconess Hosp
Memorial Hospital Of Carbon
Cnty
Memorial Hosp Of Converse Cnty
Cobre Valley Regional Medical
Center
Abrazo Scottsdale Campus
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Honorhealth Scottsdale Shea
Medical Ctr
Croft, Scott T, MD, (M), B
Cobre Valley Tonto Basin Clinic
Provider ID 001342682007
NPI: 1619934163
186 E Stephens Way
Tonto Basin, AZ 85553
(928) 479-2871 EB, P, R
Languages Spoken:
Provider: Japanese
Ages: 0-99
Hospital Affiliations:
Frances Mahon Deaconess Hosp
Memorial Hospital Of Carbon
Cnty
Memorial Hosp Of Converse Cnty
Cobre Valley Regional Medical
Center
Abrazo Scottsdale Campus
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Honorhealth Scottsdale Shea
Medical Ctr
Croft, Scott T, MD, (M), B
Cobre Valley Tonto Basin Clinic
Provider ID 001342682003
NPI: 1619934163
5880 S Hospital Dr
Globe, AZ 85501
(928) 402-1165 EB, P, R
Languages Spoken:
Provider: Japanese
Ages: 0-99
Hospital Affiliations:
Frances Mahon Deaconess Hosp
Memorial Hospital Of Carbon
Cnty
Memorial Hosp Of Converse Cnty
Cobre Valley Regional Medical
Center
Abrazo Scottsdale Campus
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Honorhealth Scottsdale Shea
Medical Ctr
Croft, Scott T, MD, (M), B
Cobre Valley Tonto Basin Clinic
Provider ID 001342682005
NPI: 1619934163
5994 S Hospital Dr
Globe, AZ 85501
(928) 425-7108 EB, P, R
Languages Spoken:
Provider: Japanese
Ages: 0-99
Hospital Affiliations:
Frances Mahon Deaconess Hosp
Memorial Hospital Of Carbon
Cnty
Memorial Hosp Of Converse Cnty
Cobre Valley Regional Medical
Center
Abrazo Scottsdale Campus
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Honorhealth Scottsdale Shea
Medical Ctr
Kelly, Lawrence J, MD, (M), B
Banner Physician Specialists
Arizona
Provider ID 002036792005
NPI: 1124014758
126 E Main St Ste D
Payson, AZ 85541
(928) 596-4800 EB, P, R
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
West Valley Hospital Medical
Center
Abrazo West Campus
Arizona - Gila Specialists / Especialistas
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
96
CSAZ.18.999.01.9.017
Sepich, Dustin J, MD, (M)
Banner Physician Specialists
Arizona
Provider ID 005548310003
NPI: 1801109152
126 E Main St Ste D
Payson, AZ 85541
(928) 596-4800 EB, P, R
Ages: 0-99
Hospital Affiliations:
Desert Springs Hospital
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
St Rose Dominican Hospital Sie
Spring Valley Hosp Med Ctr
Southern Hills Medical Center
Centennial Hills Hosp Med Ctr
Shank, Lawrence P, MD, (M), B
Banner Physician Specialists
Arizona
Provider ID 001660193006
NPI: 1144212226
126 E Main St Ste D
Payson, AZ 85541
(928) 596-4800 EB, P, R
Ages: 0-99
Hospital Affiliations:
Susan B Allen Memorial Hospital
Memorial Hospital Of Texas Cnty
St Luke Hospital
Humboldt General Hospital
Maryvale Hospital Medical Center
Abrazo Maryvale Campus
Banner Del E Webb Medical
Center
West Valley Hospital Medical
Center
Tani, Jason C, MD, (M), B
Banner Physician Specialists
Arizona
Provider ID 001409477003
NPI: 1104813013
126 E Main St Ste D
Payson, AZ 85541
(928) 596-4800 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Payson Medical Center
Banner Baywood Medical Center
Arizona Spine & Joint Hospital
Banner Gateway Medical Center
Wheeler, John C, MD, (M), B
Banner Physician Specialists
Arizona
Provider ID 005327479002
NPI: 1073700928
126 E Main St Ste D
Payson, AZ 85541
(928) 596-4800 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Banner Baywood Medical Center
Banner Desert Medical Center
Banner Gateway Medical Center
Pain Management / Tratamiento
Del Dolor
Goodman, Darenie, MD, (F)
Desert Pain & Rehab Specialists
Provider ID 002967074003
NPI: 1295992527
621 S Fifth St
Globe, AZ 85501
(928) 425-8273 E, EB, IB, P, R
Languages Spoken:
Provider: French
Staff: Spanish
Interpreter: Medical Interp
Vendor
Ages: 0-99
Hospital Affiliations:
San Gabriel Valley Medical
Center
Keck Hospital Of Usc
Goodman, Herbert D, MD, (M)
Desert Pain & Rehab Specialists
Provider ID 000713472002
NPI: 1346258472
621 S Fifth St
Globe, AZ 85501
(928) 425-8273 E, EB, IB, P, R
Languages Spoken:
Provider: French
Staff: Spanish
Interpreter: Medical Interp
Vendor
Ages: 0-99
Hospital Affiliations:
Maryvale Hospital Medical Center
Abrazo Maryvale Campus
Halter, Mitchell R, MD, (M)
Desert Pain & Rehab Specialists
Provider ID 002198541003
NPI: 1841287398
621 S Fifth St
Globe, AZ 85501
(928) 425-8273 E, EB, IB, P, R
Ages: 0-99
Hospital Affiliations:
University Medical Center
Banner University Med Ctr
Tucson Campus
Northwest Medical Center
Specialists / Especialistas Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
97
CSAZ.18.999.01.9.017
Morse, Suzanne, NP, (F)
Northern Arizona Pain Svcs
Provider ID 002748654002
NPI: 1386750511
708 S Coeur D Alene Ln Ste C
Payson, AZ 85541
(928) 474-2234 EB, P, R
Mo-Th - 8:00 AM - 5:00 PM
Fr - 8:00 AM - 12:00 PM
Ages: 0-99
Pediatric Nephrology / Nefrología
Pediátrica
Benedict, Kelly A, MD, (F)
Az Kidney Dis & Hypertension
Provider ID 005038739004
NPI: 1144429747
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Banner Desert Medical Center
St Josephs Hsp And Med Ctr
Benedict, Kelly A, MD, (F)
Az Kidney Dis & Hypertension
Provider ID 005038739004
NPI: 1144429747
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Banner Desert Medical Center
St Josephs Hsp And Med Ctr
Hsieh, Stephanie S, MD, (F), B
Az Kidney Dis & Hypertension
Provider ID 002549159003
NPI: 1760444806
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Yuma Regional Medical Center
Valleywise Health
Banner Univ Medical Cntr
Phoenix Campus
Banner Desert Medical Center
Phx Childrens Hospital
Hsieh, Stephanie S, MD, (F), B
Az Kidney Dis & Hypertension
Provider ID 002549159003
NPI: 1760444806
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Spanish
Mo-Sa - 8:00 AM - 4:30 PM
Ages: 0-99
Hospital Affiliations:
Yuma Regional Medical Center
Valleywise Health
Banner Univ Medical Cntr
Phoenix Campus
Banner Desert Medical Center
Phx Childrens Hospital
Joseph, Mark W, MD, (M), B
Az Kidney Dis & Hypertension
Provider ID 001707224072
NPI: 1740242320
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Banner Univ Medical Cntr
Phoenix Campus
Banner Desert Medical Center
Honorhealth Scottsdale Shea
Medical Ctr
Scottsdale Healthcare Shea
Medical Ctr
Scttsdle Hlth Shea
Phx Childrens Hospital
St Josephs Hsp And Med Ctr
Lindner, Clare J, MD, (F), B
Az Kidney Dis & Hypertension
Provider ID 005649204003
NPI: 1386932853
1106 N Beeline Hwy
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Germanic (Other),
Hebrew
Arizona - Gila Specialists / Especialistas
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
98
CSAZ.18.999.01.9.017
Ages: 0-99
Hospital Affiliations:
University Medical Center
Banner University Med Ctr
Tucson Campus
Valleywise Health
University Of Michigan Medical
Center
Banner Univ Medical Cntr
Phoenix Campus
Banner Desert Medical Center
Honorhealth Scottsdale Shea
Medical Ctr
Scottsdale Healthcare Shea
Medical Ctr
Lindner, Clare J, MD, (F), B
Az Kidney Dis & Hypertension
Provider ID 005649204003
NPI: 1386932853
903 E State Highway 260 Ste 2
Payson, AZ 85541
(480) 857-2381 EB, P, R
Languages Spoken:
Provider: Germanic (Other),
Hebrew
Staff: Spanish
Ages: 0-99
Hospital Affiliations:
University Medical Center
Banner University Med Ctr
Tucson Campus
Valleywise Health
University Of Michigan Medical
Center
Banner Univ Medical Cntr
Phoenix Campus
Banner Desert Medical Center
Honorhealth Scottsdale Shea
Medical Ctr
Scottsdale Healthcare Shea
Medical Ctr
Pediatric Orthopaedic Surgery /
Cirugía Oftalmológica Pediátrica
Udall, John H, MD, (M)
Banner Physician Specialists
Arizona
Provider ID 002950766002
NPI: 1649477357
117 E Main St Ste A100
Payson, AZ 85541
(928) 596-4500 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Baywood Medical Center
Banner Baywood Heart Hospital
Banner Desert Medical Center
St Josephs Hsp And Med Ctr
Banner Gateway Medical Center
Pediatric Urology / Urología
Pediátrica
Gleason, Philip E, MD, (M), B
Banner Physician Super Spec
Arizona
Provider ID 001200531004
NPI: 1871585810
803 S Ponderosa St Ste C
Payson, AZ 85541
(928) 596-4550 EB, P, R
Ages: 0-99
Hospital Affiliations:
Spectrum Health Hospitals
Flagstaff Medical Center
Banner Thunderbird Medical
Center
Banner Univ Medical Cntr
Phoenix Campus
Banner Desert Medical Center
Honorhealth Scottsdale Shea
Medical Ctr
Scottsdale Healthcare Shea
Medical Ctr
Scttsdle Hlth Shea
Physician Assistant / Asistente
Médico
Alexander, Roberto B, PA, (M)
Banner Physician Specialists
Arizona
Provider ID 003415788004
NPI: 1003878125
122 E Main St
Payson, AZ 85541
(928) 596-4600 EB, P, R
Ages: 0-99
Hospital Affiliations:
Christus St Vincent Regional Med
Ctr
Scttsdle Hlth Osb
Honorhealth Scottsdale Shea
Medical Ctr
Scottsdale Healthcare Shea
Medical Ctr
Scttsdle Hlth Shea
Specialists / Especialistas Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
99
CSAZ.18.999.01.9.017
Alexander, Roberto B, PA, (M)
Banner Physician Specialists
Arizona
Provider ID 003415788004
NPI: 1003878125
126 E Main St Ste D
Payson, AZ 85541
(928) 596-4800 EB, P, R
Ages: 0-99
Hospital Affiliations:
Christus St Vincent Regional Med
Ctr
Scttsdle Hlth Osb
Honorhealth Scottsdale Shea
Medical Ctr
Scottsdale Healthcare Shea
Medical Ctr
Scttsdle Hlth Shea
Ballou, Elise W, PA, (F)
Health Group Providers LLC
Provider ID 005789640007
NPI: 1720485147
1100 E Monroe St
Globe, AZ 85501
(602) 734-5664 EB, IB, P, PL, R
Ages: 0-99
Hospital Affiliations:
Abrazo Arrowhead Campus
Jcl Dv Hospital
Freeburg, Dominic D, PA, (M)
Banner Physician Specialists
Arizona
Provider ID 006590224001
NPI: 1407211808
122 E Main St
Payson, AZ 85541
(928) 596-4600 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Baywood Medical Center
Banner Baywood Heart Hospital
Banner Gateway Medical Center
Kitchen, Dallon R, PA, (M)
Statclinix Plc
Provider ID 005832186003
NPI: 1558744391
101 E Hwy 260 Ste G
Payson, AZ 85541
(928) 478-8905 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Koppal, Theresa D, PA, (F)
Banner Urgent Care Arizona
Provider ID 006034568003
NPI: 1033510508
101 E State Highway 260 Ste G
Payson, AZ 85541
(928) 478-8905 EB, P, R
Ages: 0-99
Mc Bride, Wade J, PA, (M)
Vhs Outpatient Clinics
Provider ID 002193296015
NPI: 1164495917
708 S Coeur D Alene Ln Ste 1
Payson, AZ 85541
(928) 472-7440 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Yuma Regional Medical Center
Banner Univ Medical Cntr
Phoenix Campus
St Josephs Hsp And Med Ctr
Mcdonald, Jennifer P, PA, (F)
Mountain Health And Wellness
Provider ID 005607787019
NPI: 1144605171
2250 Hwy 60 Ste I
Globe, AZ 85501
(928) 402-8032 EB, P, R
Ages: 0-99
Mcleod, Robert J, PA, (M)
Banner Physician Specialists
Arizona
Provider ID 005335924001
NPI: 1992193957
122 E Main St
Payson, AZ 85541
(928) 596-4600 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Baywood Medical Center
Banner Baywood Heart Hospital
Banner Gateway Medical Center
Mcminn, Sylvia E, PA, (F), B
Health Group Providers LLC
Provider ID 002897426006
NPI: 1063631760
1100 E Monroe St
Globe, AZ 85501
(602) 734-5664 EB, IB, P, PL, R
Cultural Competency: Y
Ages: 0-99
Areas of Expertise: Serious Mental
Illness
Mortenson, Duane S, PA, (M)
Sheftel & Associates Dermatology
Provider ID 003551572003
NPI: 1972719102
5886 S Hospital Dr
Globe, AZ 85501
(520) 293-5757 EB, P, R
Ages: 0-99
Peterson, Richard N, PA, (M)
Banner Urgent Care Arizona
Provider ID 003432432004
NPI: 1386949659
101 E State Highway 260 Ste G
Payson, AZ 85541
(928) 478-8905 EB, P, R
Ages: 0-99
Arizona - Gila Specialists / Especialistas
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
100
CSAZ.18.999.01.9.017
Porter, Andrew R, PA, (M)
Banner Urgent Care Arizona
Provider ID 002814236005
NPI: 1801826094
101 E State Highway 260 Ste G
Payson, AZ 85541
(928) 478-8905 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Casa Grande Regional Med Ctr
Banner Casa Grande Medical
Center
Banner Baywood Medical Center
Porter, Levi, PA, (M)
Desert Pain & Rehab Specialists
Provider ID 003182455006
NPI: 1225111834
621 S Fifth St
Globe, AZ 85501
(928) 425-8273 E, EB, IB, P, R
Ages: 0-99
Rogers, Scott T, PA, (M)
Banner Urgent Care Arizona
Provider ID 003234336005
NPI: 1689927329
101 E State Highway 260 Ste G
Payson, AZ 85541
(928) 478-8905 EB, P, R
Ages: 0-99
Rust, Jeffery, PA, (M)
Banner Urgent Care Arizona
Provider ID 002701914053
NPI: 1841240207
101 E State Highway 260 Ste G
Payson, AZ 85541
(928) 478-8905 EB, P, R
Ages: 0-99
Hospital Affiliations:
Western Arizona Regional
Medical
Banner Boswell Medical Center
Sarko, Genowefa H, PA, (F)
Southwest Behavioral Services
Provider ID 002167829002
NPI: 1225139322
404 W Aero Dr
Payson, AZ 85541
(928) 474-3303 EB, P, R
Languages Spoken:
Provider: Polish, Russian
Ages: 0-99
Scholzen, David T, PA, (M)
Banner Urgent Care Arizona
Provider ID 003349274006
NPI: 1104013515
101 E State Highway 260 Ste G
Payson, AZ 85541
(928) 478-8905 EB, P, R
Ages: 0-99
Scott, Diane M, PA, (F)
Banner Physician Specialists
Arizona
Provider ID 002701639003
NPI: 1285694299
120 E Main St Ste A
Payson, AZ 85541
(928) 596-4700 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Payson Medical Center
Banner Gateway Medical Center
Scott, Diane M, PA, (F)
Banner Physician Specialists
Arizona
Provider ID 002701639003
NPI: 1285694299
122 E Main St Ste A
Payson, AZ 85541
(928) 596-4600 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Payson Medical Center
Banner Gateway Medical Center
Scott, Diane M, PA, (F)
Banner Physician Specialists
Arizona
Provider ID 002701639003
NPI: 1285694299
126 E Main St Ste D
Payson, AZ 85541
(928) 596-4800 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Payson Medical Center
Banner Gateway Medical Center
Sorenson, David S, PA, (M)
Banner Urgent Care Arizona
Provider ID 003339140006
NPI: 1407923493
101 E State Highway 260 Ste G
Payson, AZ 85541
(928) 478-8905 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Baywood Medical Center
Specialists / Especialistas Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
101
CSAZ.18.999.01.9.017
Stallings, Shantay, PA, (F)
Banner Urgent Care Arizona
Provider ID 006334170005
NPI: 1356892640
101 E State Highway 260 Ste G
Payson, AZ 85541
(928) 478-8905 EB, P, R
Ages: 0-99
Stevenson, Troy G, PA, (M)
Horizon Health And Wellness
Provider ID 005449527019
NPI: 1972995892
2250 Hwy 60 Ste I
Globe, AZ 85501
(928) 402-8032 EB, P, R
Ages: 0-99
Stevenson, Troy G, PA, (M)
Horizon Health And Wellness
Provider ID 005449527008
NPI: 1972995892
415 W Baseline Spur
Globe, AZ 85501
(928) 402-9297 EB, P, R
Ages: 0-99
Strickland, Suzanne L, PA, (F)
Banner Urgent Care Arizona
Provider ID 005455550004
NPI: 1356731624
101 E State Highway 260 Ste G
Payson, AZ 85541
(928) 478-8905 EB, P, R
Ages: 0-99
Swanson, Jennifer, PA, (F)
Cobre Valley Regional Medical
Center
Provider ID 003576263002
NPI: 1366791071
124 N Tewksbury Blvd
Young, AZ 85554
(928) 462-3435 EB, P, R
Ages: 0-99
Swanson, Jennifer, PA, (F)
Cobre Valley Regional Medical
Center
Provider ID 003576263004
NPI: 1366791071
5880 S Hospital Dr
Globe, AZ 85501
(928) 402-1107 EB, P, R
Languages Spoken:
Staff: American Sign Language,
Spanish
Ages: 0-99
White, Andrew C, PA, (M)
Banner Urgent Care Arizona
Provider ID 007037415004
NPI: 1043791247
101 E State Highway 260 Ste G
Payson, AZ 85541
(928) 478-8905 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Wurtz, Eric S, PA, (M)
Banner Urgent Care Arizona
Provider ID 004722791003
NPI: 1659621308
101 E State Highway 260 Ste G
Payson, AZ 85541
(928) 478-8905 EB, P, R
Languages Spoken:
Provider: Filipino
Ages: 0-99
Plastic Surgery / Cirugía Plástica
Lex, Stephen F, MD, (M), B
Plastic Surgeons Of Northern Az
Provider ID 001702681004
NPI: 1215930599
405 W Main St Ste D
Payson, AZ 85541
(928) 774-2300 EB, IB, P, R
Ages: 0-99
Hospital Affiliations:
Verde Valley Medical Cntr
Kingman Regional Medical Center
Flagstaff Medical Center
Quigley, Jack B, MD, (M), B
Plastic Surgeons Of Northern Az
Provider ID 001702680008
NPI: 1861495137
405 W Main St Ste D
Payson, AZ 85541
(928) 774-2300 EB, IB, P, R
Ages: 0-99
Hospital Affiliations:
Verde Valley Medical Cntr
Kingman Regional Medical Center
Flagstaff Medical Center
Podiatry / Podiatría
Evans, Robert T, DPM, (M), B
Robert T Evans Dpm
Provider ID 002457108002
NPI: 1578532248
200 E Lone Pine Dr
Payson, AZ 85541
(928) 474-9242 EB, P, R
Ages: 0-99
Hospital Affiliations:
Jcl Dv Hospital
Honorhealth John C Lincoln
Medical Ctr
Jcl Nm Hospital
Arizona - Gila Specialists / Especialistas
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
102
CSAZ.18.999.01.9.017
Hall, Hugh R, DPM, (M)
White Mountain Foot And Ankle
Care
Provider ID 002627688002
NPI: 1952352619
5882 S Hospital Dr Ste 3
Globe, AZ 85501
(928) 532-5227 E, EB, IB, P, R
Ages: 0-99
Hospital Affiliations:
Summit Regional Medical Center
Lewis, Wesley K, DPM, (M), B
Integrated Medical Services
Provider ID 006463994004
NPI: 1639589302
111 W Cedar Ln Ste A
Payson, AZ 85541
(623) 882-1292 E, EB, IB, P, R
Ages: 0-99
Mclaws, Ivan D, DPM, (M), B
Mclaws Ivan D
Provider ID 000819060001
NPI: 1356428536
200 E Lone Pine Dr
Payson, AZ 85541
(928) 474-9242 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Banner Payson Medical Center
Robison, Glen N, DPM, (M), B
Glen N Robison Dpm
Provider ID 001895087003
NPI: 1366401606
1300 South St
Globe, AZ 85501
(480) 985-1093 EB, P, R
Ages: 0-99
Hospital Affiliations:
Cobre Valley Regional Medical
Center
Banner Baywood Medical Center
Banner Gateway Medical Center
Robison, Glen N, DPM, (M), B
Glen N Robison Dpm
Provider ID 001895087003
NPI: 1366401606
5882 S Hospital Dr Ste 2
Globe, AZ 85501
(928) 425-3338 EB, P, R
Ages: 0-99
Hospital Affiliations:
Cobre Valley Regional Medical
Center
Banner Baywood Medical Center
Banner Gateway Medical Center
Robison, Glen N, DPM, (M), B
Glen N Robison Dpm
Provider ID 001895087003
NPI: 1366401606
5882 S Hospital Dr Ste 3
Globe, AZ 85501
(928) 425-3338 E, EB, IB, P, R
Ages: 0-99
Hospital Affiliations:
Cobre Valley Regional Medical
Center
Banner Baywood Medical Center
Banner Gateway Medical Center
Pulmonary Medicine / Medicina
Pulmonar
Nguyen, Dat D, MD, (M), B
The Az Partnership For
Immunization
Provider ID 002623514006
NPI: 1982698528
5515 S Apache Ave
Globe, AZ 85501
(928) 425-3189 EB, P, R
Languages Spoken:
Provider: Vietnamese
Does Not Accept New Patients
Ages: 0-99
Hospital Affiliations:
Kingman Regional Medical Center
Salim, Muhammad M, MD, (M),
B
Muhammad M Salim Md
Provider ID 000076997001
NPI: 1760467419
5880 S Hospital Dr
Globe, AZ 85501
(480) 821-0129 EB, P, R
Ages: 0-99
Hospital Affiliations:
Detar Hospital Navarro
Tempe St Lukes Hosp A Campus
Of St Lukes
Banner Baywood Heart Hospital
Banner Desert Medical Center
Chandler Regional Medical Center
Vascular Surgery / Cirugía
Vascular
Specialists / Especialistas Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
103
CSAZ.18.999.01.9.017
Balraj, Praveen C, MD, (M), B
Banner Physician Specialists
Arizona
Provider ID 005559511002
NPI: 1447562640
122 E Main St
Payson, AZ 85541
(928) 596-4600 EB, P, R
Languages Spoken:
Provider: Tamil, Telugu
Ages: 0-99
Hospital Affiliations:
Banner Baywood Medical Center
Banner Baywood Heart Hospital
Banner Desert Medical Center
Banner Gateway Medical Center
Paolini, David J, MD, (M), B
Western Vascular Institute
Provider ID 002436520009
NPI: 1245229004
708 S Coeur D Alene Ln Ste B
Payson, AZ 85541
(480) 668-5000 EB, P, R
Cultural Competency: Y
Ages: 0-99
Hospital Affiliations:
Lovelace Westside Hospital
The Toledo Hospital
Armstrong County Mem Hospital
Banner Baywood Medical Center
Lovelace Womens Hospital
Riesenman, Paul J, MD, (M), B
Banner Physician Specialists
Arizona
Provider ID 003500083002
NPI: 1831318195
122 E Main St
Payson, AZ 85541
(928) 596-4600 EB, P, R
Ages: 0-99
Hospital Affiliations:
University Hospital
Banner Baywood Medical Center
Banner Baywood Heart Hospital
Banner Gateway Medical Center
Pinal
Cardiology / Cardiología
Tuli, Ajay, MD, (M), B
Pima Heart Physicians
Provider ID 002241188021
NPI: 1093793267
23 S Mcnab Pkwy
San Manuel, AZ 85631
(520) 297-9060 EB, P, R
Ages: 0-99
Hospital Affiliations:
Tucson Medical Center
Carondelet St Marys Hospital
Northwest Medical Center
Oro Valley Hospital
Tuli, Ajay, MD, (M), B
Pima Heart Physicians
Provider ID 002241188024
NPI: 1093793267
25 S Mcnab Pkwy
San Manuel, AZ 85631
(520) 297-9060 EB, P, R
Ages: 0-99
Hospital Affiliations:
Tucson Medical Center
Carondelet St Marys Hospital
Northwest Medical Center
Oro Valley Hospital
Internal Medicine / Medicina
Interna
Tuli, Ajay, MD, (M), B
Pima Heart Physicians
Provider ID 002241188021
NPI: 1093793267
23 S Mcnab Pkwy
San Manuel, AZ 85631
(520) 297-9060 EB, P, R
Ages: 0-99
Hospital Affiliations:
Tucson Medical Center
Carondelet St Marys Hospital
Northwest Medical Center
Oro Valley Hospital
Tuli, Ajay, MD, (M), B
Pima Heart Physicians
Provider ID 002241188024
NPI: 1093793267
25 S Mcnab Pkwy
San Manuel, AZ 85631
(520) 297-9060 EB, P, R
Ages: 0-99
Hospital Affiliations:
Tucson Medical Center
Carondelet St Marys Hospital
Northwest Medical Center
Oro Valley Hospital
Arizona - Pinal Specialists / Especialistas
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
104
CSAZ.18.999.01.9.017
Physician Assistant / Asistente
Médico
Mcdonald, Jennifer P, PA, (F)
Mountain Health And Wellness
Provider ID 005607787016
NPI: 1144605171
980 E Mt Lemmon Road
Oracle, AZ 85623
(520) 896-6019 EB, P, R
Ages: 0-99
Nelson, Thomas J, PA, (M)
Horizon Health And Wellness
Provider ID 004987683004
NPI: 1508293713
980 E Mt Lemmon Road
Oracle, AZ 85623
(520) 896-6019 EB, P, R
Ages: 0-99
Stevenson, Troy G, PA, (M)
Horizon Health And Wellness
Provider ID 005449527016
NPI: 1972995892
980 E Mt Lemmon Road
Oracle, AZ 85623
(520) 896-6019 EB, P, R
Ages: 0-99
California
Riverside
Allergy & Immunology / Alergia
E Inmunología
Brown, Hosea E, MD, (M), B
Hosea E Brown Md
Provider ID 000109610001
NPI: 1891787289
214 W Hobsonway
Blythe, CA 92225
(800) 577-6639 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Desert Regional Medical Center -
Compreh
Havasu Regional Medical Center
Palo Verde Hospital
Nevada
Clark
Cardiology / Cardiología
Jones, Jamison C, MD, (M)
Revere Health
Provider ID 003042088001
NPI: 1205031549
330 Falcon Ridge Pkwy Ste 400a
Mesquite, NV 89027
(435) 251-2900 EB, P, R
Ages: 0-99
Hospital Affiliations:
Cedar City Hospital
Dixie Regional Medical Center
Cardiovascular Disease /
Enfermedad Cardiovascular
Jones, Jamison C, MD, (M), B
Revere Health
Provider ID 003042088001
NPI: 1205031549
330 Falcon Ridge Pkwy Ste 400a
Mesquite, NV 89027
(435) 251-2900 EB, P, R
Ages: 0-99
Hospital Affiliations:
Cedar City Hospital
Dixie Regional Medical Center
Nurse Practitioner / Enfermera
Especialista
Krause, Lonny D, NP, (M)
Revere Health
Provider ID 007066489001
NPI: 1528523206
330 Falcon Ridge Pkwy Ste 400a
Mesquite, NV 89027
(435) 628-9393 EB, P, R
Ages: 0-99
Ophthalmology / Oftalmología
Carlson, Joshua N, MD, (M), B
Retina Assoc Of Southern Utah
Provider ID 003643894003
NPI: 1093943086
340 Falcon Ridge Pkwy Ste 601
Mesquite, NV 89027
(435) 216-7032 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Vanderbilt University Med Ctr
Vanderbilt University Medical
Center
Mesa View Regional Hospital
Specialists / Especialistas Nevada - Clark
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
105
CSAZ.18.999.01.9.017
Lord, Ron K, MD, (M), B
Retina Assoc Of Southern Utah
Provider ID 002363759001
NPI: 1790991107
340 Falcon Ridge Pkwy Ste 601
Mesquite, NV 89027
(866) 874-6496 EB, P, R
Ages: 0-99
Hospital Affiliations:
Truman Lakewood
Cedar City Hospital
Banner Page Hospital
Dixie Regional Medical Center
Sevier Valley Hospital
Mesa View Regional Hospital
Ophthalmology Retina Surgery /
Cirugía De Retina De
Oftalmología
Lord, Ron K, MD, (M)
Retina Assoc Of Southern Utah
Provider ID 002363759001
NPI: 1790991107
340 Falcon Ridge Pkwy Ste 601
Mesquite, NV 89027
(866) 874-6496 EB, P, R
Ages: 0-99
Hospital Affiliations:
Truman Lakewood
Cedar City Hospital
Banner Page Hospital
Dixie Regional Medical Center
Sevier Valley Hospital
Mesa View Regional Hospital
Orthopaedic Surgery / Cirugía
Ortopédica
O'brien, Aaron M, MD, (M), B
Revere Health
Provider ID 005184266003
NPI: 1114155074
330 Falcon Ridge Pkwy Ste 400a
Mesquite, NV 89027
(435) 628-9393 EB, P, R
Ages: 0-99
Hospital Affiliations:
Cleveland Clinic Foundation
Dixie Regional Medical Center
Parry, Scott A, MD, (M), B
Revere Health
Provider ID 001374575003
NPI: 1285611475
330 Falcon Ridge Pkwy Ste 400a
Mesquite, NV 89027
(435) 628-9393 EB, P, R
Languages Spoken:
Provider: French
Ages: 0-99
Hospital Affiliations:
Kane County Hospital
Dixie Regional Medical Center
Delta Community Hospital
Mesa View Regional Hospital
Parry, Todd R, MD, (M), B
Revere Health
Provider ID 002096544002
NPI: 1114905932
330 Falcon Ridge Pkwy Ste 400a
Mesquite, NV 89027
(435) 628-9393 EB, P, R
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Delta Community Hospital
Christus Good Shepherd Medical
Center
Mesa View Regional Hospital
Physical Medicine And
Rehabilitation / Physiatry /
Medicina Física Y De
Rehabilitación/Fisiatría
Johnson, Benjamin J, PT, (M)
Fit Physical Therapy Nv
Provider ID 003135476001
NPI: 1548490196
340 Falcon Ridge Pkwy Ste 500
Mesquite, NV 89027
(702) 346-3105 EB, P, R
Languages Spoken:
Provider: Spanish
Staff: Spanish
Ages: 0-99
Physician Assistant / Asistente
Médico
Cox, Brandon R, PA, (M)
Revere Health
Provider ID 005302318005
NPI: 1508275868
330 Falcon Ridge Pkwy Ste 400a
Mesquite, NV 89027
(435) 628-9393 EB, P, R
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Mcpherson, Bruce A, PA, (M)
Revere Health
Provider ID 002321601001
NPI: 1265419451
330 Falcon Ridge Pkwy Ste 400a
Mesquite, NV 89027
(435) 628-9393 EB, P, R
Ages: 0-99
Podiatry / Podiatría
Nevada - Clark Specialists / Especialistas
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
106
CSAZ.18.999.01.9.017
Peterson, Ryan T, DPM, (M)
Foot & Ankle Institute
Provider ID 003323809001
NPI: 1245486307
340 Falcon Ridge Pkwy Bldg A
Mesquite, NV 89027
(702) 346-7678 EB, P, R
Ages: 0-99
Peterson, Ryan T, DPM, (M)
Foot & Ankle Institute
Provider ID 003323809001
NPI: 1245486307
340 Falcon Ridge Pkwy Ste 300a
Mesquite, NV 89027
(702) 346-7678 EB, P, R
Ages: 0-99
Reber, Leon K, DPM, (M), B
Foot & Ankle Institute
Provider ID 002644864001
NPI: 1336179886
340 Falcon Ridge Pkwy Bldg Stea
Mesquite, NV 89027
(702) 346-7678 EB, P, R
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Smith, Lary J, DPM, (M), B
Foot & Ankle Institute
Provider ID 001363347001
NPI: 1093713539
340 Falcon Ridge Pkwy Bldg A
Mesquite, NV 89027
(702) 346-7678 EB, P, R
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Smith, Lary J, DPM, (M), B
Foot & Ankle Institute
Provider ID 001363347001
NPI: 1093713539
340 Falcon Ridge Pkwy Ste 300a
Mesquite, NV 89027
(702) 346-7678 EB, P, R
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Pulmonary Medicine / Medicina
Pulmonar
Saifee, Mustufa T, MD, (M), B
Advanced Pulmon Sleep Disord &
Int Med
Provider ID 002207312001
NPI: 1568428357
1301 Bertha Howe Ave Ste 10
Mesquite, NV 89027
(435) 688-7770
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Saifee, Mustufa T, MD, (M), B
Advanced Pulmon Sleep Disord &
Int Med
Provider ID 002207312001
NPI: 1568428357
1301 Bertha Howe Ave Ste 11
Mesquite, NV 89027
(435) 313-7770
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Utah
Kane
Cardiology / Cardiología
Jones, Jamison C, MD, (M)
Revere Health
Provider ID 003042088001
NPI: 1205031549
355 N Main St
Kanab, UT 84741
(435) 251-2900 EB, IB, P, R
Ages: 0-99
Hospital Affiliations:
Cedar City Hospital
Dixie Regional Medical Center
Cardiovascular Disease /
Enfermedad Cardiovascular
Jones, Jamison C, MD, (M), B
Revere Health
Provider ID 003042088001
NPI: 1205031549
355 N Main St
Kanab, UT 84741
(435) 251-2900 EB, IB, P, R
Ages: 0-99
Hospital Affiliations:
Cedar City Hospital
Dixie Regional Medical Center
Orthopaedic Surgery / Cirugía
Ortopédica
Parry, Scott A, MD, (M), B
Revere Health
Provider ID 001374575003
NPI: 1285611475
355 N Main St
Kanab, UT 84741
(435) 628-9393 EB, IB, P, R
Languages Spoken:
Provider: French
Specialists / Especialistas Utah - Kane
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
107
CSAZ.18.999.01.9.017
Ages: 0-99
Hospital Affiliations:
Kane County Hospital
Dixie Regional Medical Center
Delta Community Hospital
Mesa View Regional Hospital
Washington
Cardiology / Cardiología
Jones, Jamison C, MD, (M)
Revere Health
Provider ID 003042088001
NPI: 1205031549
1380 E Medical Center Dr # 4100
Saint George, UT 84790
(435) 251-2900 EB, P, R
Ages: 0-99
Hospital Affiliations:
Cedar City Hospital
Dixie Regional Medical Center
Cardiovascular Disease /
Enfermedad Cardiovascular
Boorman, David C, MD, (M), B
Revere Health
Provider ID 000374330004
NPI: 1659344471
1380 E Medical Center Dr # 4100
Saint George, UT 84790
(435) 251-2900 EB, P, R
Ages: 0-99
Hospital Affiliations:
Alta View Hospital
Cedar City Hospital
Dixie Regional Medical Center
Delta Community Hospital
Jones, Jamison C, MD, (M), B
Revere Health
Provider ID 003042088001
NPI: 1205031549
1380 E Medical Center Dr # 4100
Saint George, UT 84790
(435) 251-2900 EB, P, R
Ages: 0-99
Hospital Affiliations:
Cedar City Hospital
Dixie Regional Medical Center
Nimer, Lynn R, MD, (M), B
Revere Health
Provider ID 001166033003
NPI: 1689635922
1380 E Medical Cntr Dr Ste 4100
St George, UT 84790
(435) 251-2900 EB, P, R
Ages: 0-99
Hospital Affiliations:
Cedar City Hospital
Dixie Regional Medical Center
Family Nurse Practitioner /
Enfermera De Familia
Andersen, Nisha D, NP, (F)
Foot & Ankle Institute
Provider ID 005957686003
NPI: 1679938831
754 S Main St
St George, UT 84770
(435) 628-2671 EB, P, R
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Andersen, Nisha D, NP, (F)
Foot & Ankle Institute
Provider ID 005957686002
NPI: 1679938831
754 S Main St Ste 3
Saint George, UT 84770
(435) 628-2671 EB, P, R
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
General Surgery / Cirugía
Black, Cameron T, MD, (M)
Utah Surgical Associates
Provider ID 005372430002
NPI: 1679916225
1490 E Foremaster Dr Ste 200
Saint George, UT 84790
(435) 628-1641 EB, P, R
Ages: 0-99
Hospital Affiliations:
Cedar City Hospital
Dixie Regional Medical Center
Day, Trevor J, DO, (M)
Utah Surgical Associates
Provider ID 006767478001
NPI: 1861732257
1490 E Foremaster Dr Ste 200
Saint George, UT 84790
(435) 628-1641 EB, P, R
Ages: 0-99
Jennings, Cameron S, MD, (M)
Utah Surgical Associates
Provider ID 006492057001
NPI: 1790044527
1380 E Medical Center Dr
Saint George, UT 84790
(435) 628-1641 EB, P, R
Ages: 0-99
Utah - Washington Specialists / Especialistas
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
108
CSAZ.18.999.01.9.017
Jennings, Cameron S, MD, (M)
Utah Surgical Associates
Provider ID 006492057001
NPI: 1790044527
1490 E Foremaster Dr Ste 200
Saint George, UT 84790
(435) 628-1641 EB, P, R
Ages: 0-99
Myers, Brad A, MD, (M), B
Utah Surgical Associates
Provider ID 000964008002
NPI: 1700986635
1380 E Medical Center Dr
Saint George, UT 84790
(435) 628-1641 EB, P, R
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Speakman, J Jared, MD, (M), B
Utah Surgical Associates
Provider ID 002214517002
NPI: 1639279573
1380 E Medical Center Dr
Saint George, UT 84790
(435) 628-1641 EB, P, R
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Delta Community Hospital
Neurological Surgery / Cirugía
Neurológica
Garber, Jason E, MD, (M), B
Western Reg Ctr For Brn/Spine
Surg
Provider ID 002079516001
NPI: 1164489480
1404 W Sunriver Pkwy
Saint George, UT 84790
(702) 835-0088 EB, P, R
Ages: 0-99
Hospital Affiliations:
Froedtert Memorial Lutheran
Hosp
University Med Ctr Of Southern
Nevada
Valley Hospital Medical Center
Desert Springs Hospital
Summerlin Hospital Medical Ctr
Centennial Hills Hosp Med Ctr
Nurse Practitioner / Enfermera
Especialista
Andersen, Nisha D, NP, (F)
Foot & Ankle Institute
Provider ID 005957686003
NPI: 1679938831
754 S Main St
St George, UT 84770
(435) 628-2671 EB, P, R
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Andersen, Nisha D, NP, (F)
Foot & Ankle Institute
Provider ID 005957686002
NPI: 1679938831
754 S Main St Ste 3
Saint George, UT 84770
(435) 628-2671 EB, P, R
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Barton, Deborah D, NP, (F)
Revere Health
Provider ID 001777835004
NPI: 1548234222
1380 E Medical Center Dr # 4100
Saint George, UT 84790
(435) 251-2900 EB, P, R
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Carlile, Maranda S, NP, (F)
Southwest Spine & Pain Care
Specialists
Provider ID 006463914009
NPI: 1376078196
652 S Medical Center Dr Ste 110
Saint George, UT 84790
(435) 265-2424 EB, P, R
Ages: 0-99
Gurley, Mindy R, NP, (F)
Revere Health
Provider ID 006900907002
NPI: 1053899690
1380 E Medical Center Dr # 4100
Saint George, UT 84790
(435) 251-2900 EB, P, R
Ages: 0-99
Hospital Affiliations:
Parkview Hospital
Krause, Lonny D, NP, (M)
Revere Health
Provider ID 007066489001
NPI: 1528523206
1380 E Medical Center Dr # 4100
Saint George, UT 84790
(435) 251-2900 EB, P, R
Ages: 0-99
Specialists / Especialistas Utah - Washington
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
109
CSAZ.18.999.01.9.017
Parry, Ami, NP, (F), B
Revere Health
Provider ID 007160533001
NPI: 1750942637
736 S 900 E Ste 203
St George, UT 84790
(435) 673-6131 EB, P, R
Ages: 0-99
Ophthalmology / Oftalmología
Carlson, Joshua N, MD, (M), B
Retina Assoc Of Southern Utah
Provider ID 003643894003
NPI: 1093943086
230 N 1680 E Bldg F
Saint George, UT 84790
(866) 874-6496 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Vanderbilt University Med Ctr
Vanderbilt University Medical
Center
Mesa View Regional Hospital
Lord, Ron K, MD, (M), B
Retina Assoc Of Southern Utah
Provider ID 002363759001
NPI: 1790991107
230 N 1680 E Bldg F
Saint George, UT 84790
(866) 874-6496 EB, P, R
Web address: www.southernutahreti
na.com
Ages: 0-99
Hospital Affiliations:
Truman Lakewood
Cedar City Hospital
Banner Page Hospital
Dixie Regional Medical Center
Sevier Valley Hospital
Mesa View Regional Hospital
Ophthalmology Retina Surgery /
Cirugía De Retina De
Oftalmología
Lord, Ron K, MD, (M)
Retina Assoc Of Southern Utah
Provider ID 002363759001
NPI: 1790991107
230 N 1680 E Bldg F
Saint George, UT 84790
(866) 874-6496 EB, P, R
Web address: www.southernutahreti
na.com
Ages: 0-99
Hospital Affiliations:
Truman Lakewood
Cedar City Hospital
Banner Page Hospital
Dixie Regional Medical Center
Sevier Valley Hospital
Mesa View Regional Hospital
Orthopaedic Surgery / Cirugía
Ortopédica
Clark, Randy R, MD, (M), B
Revere Health
Provider ID 003486543002
NPI: 1679781140
1490 E Foremaster Dr Ste 150
Saint George, UT 84790
(435) 628-9393 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Los Robles Regional Med Ctr
Dixie Regional Medical Center
Valley Presbyterian Hospital
Clark, Randy R, MD, (M), B
Revere Health
Provider ID 003486543002
NPI: 1679781140
736 S 900 E Ste 203
Saint George, UT 84790
(435) 628-9393 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Los Robles Regional Med Ctr
Dixie Regional Medical Center
Valley Presbyterian Hospital
Green, Michael R, MD, (M), B
Dr Michael R Green
Provider ID 001274576001
NPI: 1356384226
1490 E Foremaster Dr Ste 260
Saint George, UT 84790
(435) 688-0156 EB, P, R
Languages Spoken:
Provider: Spanish
Utah - Washington Specialists / Especialistas
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
110
CSAZ.18.999.01.9.017
Mo - 8:00 AM - 5:00 PM
Tu,We,Th - 9:00 AM - 5:00 PM
Fr - 9:00 AM - 1:00 PM
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Delta Community Hospital
O'brien, Aaron M, MD, (M), B
Revere Health
Provider ID 005184266003
NPI: 1114155074
1490 E Foremaster Dr Ste 150
Saint George, UT 84790
(435) 628-9393 EB, P, R
Ages: 0-99
Hospital Affiliations:
Cleveland Clinic Foundation
Dixie Regional Medical Center
Parry, Scott A, MD, (M), B
Revere Health
Provider ID 001374575003
NPI: 1285611475
1490 E Foremaster Dr Ste 150
Saint George, UT 84790
(435) 628-9393 EB, P, R
Languages Spoken:
Provider: French
Ages: 0-99
Hospital Affiliations:
Kane County Hospital
Dixie Regional Medical Center
Delta Community Hospital
Mesa View Regional Hospital
Parry, Todd R, MD, (M), B
Revere Health
Provider ID 002096544002
NPI: 1114905932
1490 E Foremaster Dr Ste 150
Saint George, UT 84790
(435) 628-9393 EB, P, R
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Delta Community Hospital
Christus Good Shepherd Medical
Center
Mesa View Regional Hospital
Sutak, Alan K, MD, (M)
Revere Health
Provider ID 005161088002
NPI: 1679915847
1490 E Foremaster Dr Ste 150
Saint George, UT 84790
(435) 628-9393 EB, P, R
Mo-Fr - 9:00 AM - 5:00 PM
Ages: 0-99
Hospital Affiliations:
Duke Regional Hospital
Otolaryngology / Otolaringología
Chase, Steven P, MD, (M), B
Southern Utah Ear Nose Throat
Provider ID 002547497003
NPI: 1831108042
617 E Riverside Dr Ste 201
Saint George, UT 84790
(435) 628-3334 EB, P, R
Languages Spoken:
Provider: French
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Doxey, G P, MD, (M), B
Southern Utah Ear Nose Throat
Provider ID 000066097003
NPI: 1245298959
617 E Riverside Dr Ste 201
Saint George, UT 84790
(435) 628-3334 EB, P, R
Languages Spoken:
Provider: Italian, Spanish
Ages: 0-99
Hospital Affiliations:
Cedar City Hospital
Dixie Regional Medical Center
Gardner, Kent E, MD, (M), B
Southern Utah Ear Nose Throat
Provider ID 001873930003
NPI: 1881702355
617 E Riverside Dr Ste 201
Saint George, UT 84790
(435) 628-3334 EB, P, R
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Jacob, Joseph R, MD, (M), B
Southern Utah Ear Nose Throat
Provider ID 005484734002
NPI: 1134446891
617 E Riverside Dr Ste 201
Saint George, UT 84790
(435) 628-3334 EB, P, R
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Specialists / Especialistas Utah - Washington
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
111
CSAZ.18.999.01.9.017
Vaughan, Andrew H, MD, (M), B
Southern Utah Ear Nose Throat
Provider ID 003070655002
NPI: 1164684643
617 E Riverside Dr Ste 201
Saint George, UT 84790
(435) 628-3334 EB, P, R
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Pain Management / Tratamiento
Del Dolor
Christensen, Bryt A, MD, (M), B
Southwest Spine & Pain Care
Specialists
Provider ID 005564439001
NPI: 1710203047
2051 Red Hill Pkway Ste 7
St George, UT 84790
(435) 656-2424 EB, P, R
Languages Spoken:
Provider: Russian
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Christensen, Bryt A, MD, (M), B
Southwest Spine & Pain Care
Specialists
Provider ID 005564439001
NPI: 1710203047
301 N 200 E Ste 2a
St George, UT 84770
(435) 688-7246 EB, P, R
Languages Spoken:
Provider: Russian
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Christensen, Bryt A, MD, (M), B
Southwest Spine & Pain Care
Specialists
Provider ID 005564439001
NPI: 1710203047
652 S Medical Center Dr Ste 110
Saint George, UT 84790
(435) 656-2424 EB, P, R
Languages Spoken:
Provider: Russian
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Frieden, Derek L, MD, (M), B
Southwest Spine & Pain Care
Specialists
Provider ID 002460730001
NPI: 1528059201
2051 E Red Hills Pkwy Ste 7
Saint George, UT 84770
(435) 656-2424 EB, P, R
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Sevier Valley Hospital
Frieden, Derek L, MD, (M), B
Southwest Spine & Pain Care
Specialists
Provider ID 002460730001
NPI: 1528059201
2107 W Sunset Blvd Ste 102
Saint George, UT 84770
(435) 656-2424 EB, P, R
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Sevier Valley Hospital
Frieden, Derek L, MD, (M), B
Southwest Spine & Pain Care
Specialists
Provider ID 002460730001
NPI: 1528059201
652 S Medical Center Dr Ste 110
Saint George, UT 84790
(435) 215-0228 EB, P, R
Languages Spoken:
Staff: Spanish
Mo-Th - 8:00 AM - 5:00 PM
Fr - 8:00 AM - 1:00 PM
Web address: www.southwestspinea
ndpain.com
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Sevier Valley Hospital
Hillstead, Alan P, MD, (M)
Southwest Spine & Pain Care
Specialists
Provider ID 003641599008
NPI: 1144431958
2051 E Red Hills Pkwy Ste 7
Saint George, UT 84770
(435) 656-2424 EB, P, R
Ages: 0-99
Hospital Affiliations:
Cedar City Hospital
Dixie Regional Medical Center
Sevier Valley Hospital
Utah - Washington Specialists / Especialistas
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
112
CSAZ.18.999.01.9.017
Hillstead, Alan P, MD, (M)
Southwest Spine & Pain Care
Specialists
Provider ID 003641599005
NPI: 1144431958
652 S Medical Center Dr Ste 110
Saint George, UT 84790
(435) 656-2424 EB, P, R
Ages: 0-99
Hospital Affiliations:
Cedar City Hospital
Dixie Regional Medical Center
Sevier Valley Hospital
Physical Medicine And
Rehabilitation / Physiatry /
Medicina Física Y De
Rehabilitación/Fisiatría
Christensen, Bryt A, MD, (M), B
Southwest Spine & Pain Care
Specialists
Provider ID 005564439001
NPI: 1710203047
2051 Red Hill Pkway Ste 7
St George, UT 84790
(435) 656-2424 EB, P, R
Languages Spoken:
Provider: Russian
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Christensen, Bryt A, MD, (M), B
Southwest Spine & Pain Care
Specialists
Provider ID 005564439001
NPI: 1710203047
301 N 200 E Ste 2a
St George, UT 84770
(435) 688-7246 EB, P, R
Languages Spoken:
Provider: Russian
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Christensen, Bryt A, MD, (M), B
Southwest Spine & Pain Care
Specialists
Provider ID 005564439001
NPI: 1710203047
652 S Medical Center Dr Ste 110
Saint George, UT 84790
(435) 656-2424 EB, P, R
Languages Spoken:
Provider: Russian
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Root, Bradley D, DO, (M)
Revere Health
Provider ID 001732894002
NPI: 1154312197
1424 E Foremaster Dr Ste 120
Saint George, UT 84790
(435) 656-8800 EB, P, R
Languages Spoken:
Provider: Dutch
Mo-Fr - 7:00 AM - 5:00 PM
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Root, Max R, MD, (M)
Revere Health
Provider ID 000058093002
NPI: 1295725380
1424 E Foremaster Dr Ste 120
Saint George, UT 84790
(435) 656-8800 EB, P, R
Languages Spoken:
Provider: Dutch
Ages: 0-99
Hospital Affiliations:
Cedar City Hospital
Dixie Regional Medical Center
Physician Assistant / Asistente
Médico
Aston, Nathan W, PA, (M)
Revere Health
Provider ID 003361194002
NPI: 1568754364
1490 E Foremaster Dr Ste 150
Saint George, UT 84790
(435) 628-9393 EB, P, R
Ages: 0-99
Cox, Brandon R, PA, (M)
Revere Health
Provider ID 005302318001
NPI: 1508275868
1490 E Foremaster Dr Ste 150
Saint George, UT 84790
(435) 628-9393 EB, P, R
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Dickson, Alysha N, PA, (F)
Revere Health
Provider ID 006569969001
NPI: 1275081358
1490 E Foremaster Dr Ste 150
Saint George, UT 84790
(435) 628-9393 EB, P, R
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Specialists / Especialistas Utah - Washington
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
113
CSAZ.18.999.01.9.017
Johnson, Dayne A, PA, (M)
Southwest Spine & Pain Care
Specialists
Provider ID 003311419001
NPI: 1669505178
652 S Medical Center Dr Ste 110
Saint George, UT 84790
(435) 656-2424 EB, P, R
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Kaonohi, Leighton K, PA, (M)
Revere Health
Provider ID 003711007002
NPI: 1548518343
1490 E Foremaster Dr Ste 150
Saint George, UT 84790
(435) 628-9393 EB, P, R
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Mcpherson, Bruce A, PA, (M)
Revere Health
Provider ID 002321601001
NPI: 1265419451
1490 E Foremaster Dr Ste 150
Saint George, UT 84790
(435) 628-9393 EB, P, R
Ages: 0-99
Petersen, Colby B, PA, (M)
Revere Health
Provider ID 002743045001
NPI: 1740229913
1380 E Medical Center Dr # 4100
Saint George, UT 84790
(435) 251-2900 EB, P, R
Ages: 0-99
Stucki, Sean J, PA, (M)
Revere Health
Provider ID 006450938001
NPI: 1245296383
1424 E Foremaster Dr Ste 120
Saint George, UT 84790
(435) 656-8800 EB, P, R
Mo-Fr - 7:00 AM - 5:00 PM
Ages: 0-99
Swift, Travis J, PA, (M)
Utah Surgical Associates
Provider ID 003378330003
NPI: 1053691238
1380 E Medical Center Dr
Saint George, UT 84790
(435) 628-1641 EB, P, R
Mo-Fr - 9:00 AM - 5:00 PM
Ages: 0-99
Hospital Affiliations:
Banner Thunderbird Medical
Center
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Banner Desert Medical Center
Banner Estrella Medical Center
Banner Gateway Medical Center
Swift, Travis J, PA, (M)
Utah Surgical Associates
Provider ID 003378330003
NPI: 1053691238
1490 E Foremaster Dr Ste 200
Saint George, UT 84790
(435) 628-1641 EB, P, R
Mo-Fr - 9:00 AM - 5:00 PM
Ages: 0-99
Hospital Affiliations:
Banner Thunderbird Medical
Center
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Banner Desert Medical Center
Banner Estrella Medical Center
Banner Gateway Medical Center
Podiatry / Podiatría
Burton, Stephen K, DPM, (M), B
Foot & Ankle Institute
Provider ID 000404217001
NPI: 1306843099
754 S Main St Ste 3
Saint George, UT 84770
(435) 628-2671 EB, P, R
Web address: www.feetnet.com
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Peterson, Ryan T, DPM, (M)
Foot & Ankle Institute
Provider ID 003323809001
NPI: 1245486307
1380 E Medical Center Dr
Saint George, UT 84790
(435) 628-2671 EB, P, R
Ages: 0-99
Utah - Washington Specialists / Especialistas
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
114
CSAZ.18.999.01.9.017
Peterson, Ryan T, DPM, (M)
Foot & Ankle Institute
Provider ID 003323809001
NPI: 1245486307
754 S Main St Ste 3
Saint George, UT 84770
(435) 628-2671 EB, P, R
Ages: 0-99
Powell, Andrew B, DPM, (M), B
Foot & Ankle Institute
Provider ID 002094172003
NPI: 1861499568
754 S Main St Ste 3
Saint George, UT 84770
(435) 628-2671 EB, P, R
Web address: www.feetnet.com
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Reber, Keith R, DPM, (M), B
Foot & Ankle Institute
Provider ID 000404218001
NPI: 1669479358
754 S Main St Ste 3
Saint George, UT 84770
(435) 628-2671 EB, P, R
Web address: www.feetnet.com
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Reber, Leon K, DPM, (M), B
Foot & Ankle Institute
Provider ID 002644864001
NPI: 1336179886
754 S Main St Ste 3
Saint George, UT 84770
(435) 628-2671 EB, P, R
Languages Spoken:
Staff: Spanish
Web address: www.feetnet.com
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Smith, Lary J, DPM, (M), B
Foot & Ankle Institute
Provider ID 001363347001
NPI: 1093713539
754 S Main St Ste 3
Saint George, UT 84770
(435) 628-2671 EB, P, R
Web address: www.feetnet.com
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Van Gils, Carl C, DPM, (M)
Foot & Ankle Institute
Provider ID 001891628002
NPI: 1518964212
754 S Main St Ste 3
Saint George, UT 84770
(435) 628-2671 EB, P, R
Languages Spoken:
Staff: Spanish
Mo-Fr - 9:00 AM - 5:00 PM
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Delta Community Hospital
Pulmonary Medicine / Medicina
Pulmonar
Saifee, Mustufa T, MD, (M), B
Advanced Pulmon Sleep Disord &
Int Med
Provider ID 002207312001
NPI: 1568428357
1380 E Medical Center Dr
Saint George, UT 84790
(435) 251-2600 EB, P, R
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Saifee, Mustufa T, MD, (M), B
Advanced Pulmon Sleep Disord &
Int Med
Provider ID 002207312001
NPI: 1568428357
640 E 700 S Ste 105
Saint George, UT 84770
(435) 688-7770
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Radiation Oncology / Oncología
De Radiación
Richards, Ray S, MD, (M), B
Gammawest Brachytherapy
Provider ID 000828200002
NPI: 1063551695
1490 E Foremaster Dr Bldg C
Saint George, UT 84790
(801) 359-8956 EB, P, R
Languages Spoken:
Provider: Japanese
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Delta Community Hospital
Salt Lake Regional Med Ctr
Timpanogos Regional Hospital
Ogden Regional Medical Center
Specialists / Especialistas Utah - Washington
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
115
CSAZ.18.999.01.9.017
Arizona
Gila
Dentistry / Odontología
King, Shellese A, DDS, (F)
Provider ID 000025430200
NPI: 1790740512
410 S Sixth St
Globe, AZ 85501
(928) 425-0972
Languages Spoken:
Provider: Arabic, Hindi, Spanish,
English
Mo-Th - 7:00 AM - 5:00 PM
Fr - 7:00 AM - 4:00 PM
Sa - 8:00 AM - 2:00 PM
Ages: 0-99
Mandap, Marissa P, DMD, (F)
Provider ID 000070473700
NPI: 1104018886
410 S Sixth St
Globe, AZ 85501
(928) 425-0972
Languages Spoken:
Provider: Arabic, Hindi, Spanish,
English
Mo-Th - 7:00 AM - 5:00 PM
Fr - 7:00 AM - 4:00 PM
Sa - 8:00 AM - 2:00 PM
Ages: 0-99
Arizona - Gila Dental Providers / Proveedores De Servicios Dentales
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
116
CSAZ.18.999.01.9.017
Arizona
Gila
Optometry / Optometría
Woods, Russell, OD, (M)
Provider ID 815100001536
NPI: 1609832054
520 S. Hill Street
Globe, AZ 85501
(928) 425-8989 P
Cultural Competency: Y
Web address: nationwidevision.com
Ages: 0-99
Pinal
Optometry / Optometría
Ethington, Roger, OD, (M)
Provider ID 835000001530
NPI: 1679545776
371 West Central
Coolidge, AZ 85218
(520) 723-3000 P
Cultural Competency: Y
Web address: nationwidevision.com
Ages: 0-99
Jackson, Jeffrey, OD, (M)
Provider ID 837800001601
NPI: 1003014051
560 N Camino Mercado Ste 1
Casa Grande, AZ 85222
(520) 426-9224 P
Cultural Competency: Y
Web address: nationwidevision.com
Ages: 0-99
Walker, Bradley, OD, (M)
Provider ID 831200001530
NPI: 1003889460
371 West Central
Coolidge, AZ 85218
(520) 723-3000 P
Cultural Competency: Y
Web address: nationwidevision.com
Ages: 0-99
Nationwide Vision Providers / Proveedores De NationwideVision Arizona - Pinal
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
117
CSAZ.18.999.01.9.017
Arizona
Gila
Pharmacy / Farmacia
Bashas
Provider ID 0352409
NPI: 1972684181
142 E Highway 260
Payson, AZ 85541
(928) 474-7039 X N
Languages Spoken:
Provider: English, Spanish,
French
Mo-Fr - 8:00 AM - 8:00 PM
Sa - 9:00 AM - 6:00 PM
Su - 10:00 AM - 5:00 PM
Ages: 0-99
Cobre Valley Pharmacy
Provider ID 0322583
NPI: 1639384233
5880 S Hospital Drive
Pharmacy Dept
Globe, AZ 85501
(928) 402-1192
Languages Spoken:
Provider: English, Spanish
Sa - 8:00 AM - 2:00 PM
Ages: 0-99
Cvs Pharmacy #
Provider ID 0305955
NPI: 1659371854
100 N Broad St
Globe, AZ 85501
(928) 425-5777 X N
Languages Spoken:
Provider: Spanish, English
Ages: 0-99
Frys Food And Drug
Provider ID 0318798
NPI: 1801838420
2115 Us Highway 60 Suite 200
Miami, AZ 85539
(928) 425-8165 X N
Languages Spoken:
Provider: English
Mo-Fr - 9:00 AM - 9:00 PM
Sa - 9:00 AM - 6:00 PM
Su - 10:00 AM - 6:00 PM
Ages: 0-99
Genoa Healthcare, LLC
Provider ID 0357055
NPI: 1255630661
404 W. Aero Dr
Payson, AZ 85547
(928) 238-3024
Languages Spoken:
Provider: English
Mo-Fr - 8:30 AM - 5:00 PM
Ages: 0-99
Safeway Pharmacy #1536
Provider ID 0322292
NPI: 1700815750
401 E Hwy 260
Payson, AZ 85541
(928) 472-8242 EB, IB, P, R, S
X N
Languages Spoken:
Provider: English
Mo-Fr - 8:00 AM - 8:00 PM
Sa - 9:00 AM - 6:00 PM
Su - 10:00 AM - 6:00 PM
Ages: 0-99
Walgreens #6533
Provider ID 0315463
NPI: 1033124375
100 S Beeline Hwy
Payson, AZ 85541
(928) 474-1599 X N
Languages Spoken:
Provider: English
Mo-Fr - 8:00 AM - 8:00 PM
Sa,Su - 9:00 AM - 5:00 PM
Ages: 0-99
Walmart Pharmacy 10-1334
Provider ID 0316681
NPI: 1598783920
100 South Ragus Rd
Claypool, AZ 85532
(928) 425-7661 E, EB, IB, P, R,
S, T X N
Mo-Sa - 9:00 AM - 6:00 PM
Su - 10:00 AM - 6:00 PM
Cultural Competency: Y
Ages: 0-99
Walmart Pharmacy 10-1369
Provider ID 0316908
NPI: 1255358461
300 N Beeline Hwy
Payson, AZ 85541
(928) 474-0034 E, EB, IB, P, R,
S, T X N
Mo-Fr - 8:00 AM - 9:00 PM
Sa - 9:00 AM - 7:00 PM
Su - 10:00 AM - 7:00 PM
Cultural Competency: Y
Ages: 0-99
Pinal
Pharmacy / Farmacia
Arizona - Gila Pharmacy / Farmacia
All providers are proficient in English unless otherwise noted. These provider are AHCCCS Complete(Medicaid + CRS Fully Integrated + CRS Partially Integrated only providers.
118
CSAZ.18.999.01.9.017
Sun Life Family Health Center
Provider ID 0324070
NPI: 1851457295
23 S Mcnab Pkwy
San Manuel, AZ 85631
(520) 385-2236 X N
Languages Spoken:
Provider: English, Spanish
Web address: www.sunlifepharmac
yaz.com
Ages: 0-99
Pharmacy / Farmacia Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services
119
CSAZ.18.999.01.9.017
Arizona
Gila
Critical Care / Cuidado Crítico
Salim, Muhammad M
Provider ID 000076997001
NPI: 1760467419
5880 S Hospital Dr
Globe, AZ 85501
(480) 821-0129 EB, P, R
Hospital Affiliations:
Detar Hospital Navarro
Tempe St Lukes Hosp A Campus
Of St Lukes
Banner Baywood Heart Hospital
Banner Desert Medical Center
Chandler Regional Medical Center
Dialysis Center / Centro De
Diálisis
Rcg Globe
Provider ID 002768418001
NPI: 1306958111
2250 Us Hwy 60 Ste 02
Miami, AZ 85539
(928) 425-2624 EB, P, R
Durable Medical Equipment /
Equipo Médico Duradero
Preferred Homecare
Provider ID 001957929001
NPI: 1306886700
119 W Aero Dr
Payson, AZ 85541
(928) 474-6293 EB, P, R
Web address: www.preferredhomec
are.com
Home Health Agency / Agencia
De Cuidado De La Salud A
Domicilio
Banner Home Care Arizona
Provider ID 006874088001
NPI: 1821031485
708 E State Highway 260 Ste A1
Payson, AZ 85541
(928) 472-5245 EB, P, R
Web address: www.bannerhealth.co
m/locations
Copper State Home Health
Provider ID 006591755003
NPI: 1972999100
966 N Broad St Ste 7
Globe, AZ 85501
(928) 200-9708 EB, P, R
Kc's Home Health Care
Provider ID 002743103001
NPI: 1174576672
114 E State Highway 260
Payson, AZ 85541
(928) 468-5242 EB, P, R
Hospice / Centro De Cuidados
Paliativos
Aviant Hospice Gila
Provider ID 006258610001
NPI: 1952578957
136 S Broad St
Globe, AZ 85501
(928) 425-5400 EB, P, R
Hospice Compassus
Provider ID 003689467001
NPI: 1023048857
511 S Mud Springs Rd
Payson, AZ 85541
(928) 238-3211 EB, P, R
Thema Health Services
Provider ID 006489617001
NPI: 1811981566
2123 Sunset Pt Ste B3
Miami, AZ 85539
(602) 889-4400 EB, P, R
Occupational Therapy / Terapia
Ocupacional
Beecham, Christine A
Provider ID 006097981003
NPI: 1528412509
126 E Main St Ste C
Payson, AZ 85541
(928) 471-3445 EB, P, R
Blanc, Carol A
Provider ID 006090364003
NPI: 1558715052
126 E Main St Ste C
Payson, AZ 85541
(928) 471-3445 EB, P, R
Ideal Therapies
Provider ID 005394143001
NPI: 1245629237
603 N Double Tree Cir
Payson, AZ 85541
(928) 301-4397 EB, P, R
Jones, Holly R
Provider ID 006097946002
NPI: 1497109011
126 E Main St Ste C
Payson, AZ 85541
(928) 468-8907 EB, P, R
Lindstrom, Rebecca T
Provider ID 006797877001
NPI: 1902230758
126 E Main St Ste C
Payson, AZ 85541
(928) 471-3445 EB, P, R
Arizona - Gila Ancillary Providers / Proveedores Auxiliares
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
120
CSAZ.18.999.01.9.017
Tew, Debbie M
Provider ID 006089071003
NPI: 1265603609
126 E Main St Ste C
Payson, AZ 85541
(928) 468-8907 EB, P, R
Orthotics/Prosthetics /
Ortesis/Prótesis
Hanger Prosthetics & Orthotics
West
Provider ID 006376259001
NPI: 1780758672
1106 N Beeline Hwy
Payson, AZ 85541
(928) 537-5119 EB, P, R
Physical Therapy / Fisioterapia
Ahern, Naquita
Provider ID 006498837001
NPI: 1114447653
708 S Coeur D Alene Ln Ste B
Payson, AZ 85541
(928) 468-8610 EB, P, R
Bartow, Brian E
Provider ID 005894168002
NPI: 1295134914
126 E Main St Ste C
Payson, AZ 85541
(928) 468-8907 EB, P, R
Bernstein, Desmond J
Provider ID 006112357002
NPI: 1942659651
126 E Main St Ste C
Payson, AZ 85541
(928) 471-3445 EB, P, R
Languages Spoken:
Provider: Spanish
Bludworth, Lesley M
Provider ID 002843890006
NPI: 1568501443
126 E Main St Ste C
Payson, AZ 85541
(928) 471-3445 EB, P, R
Languages Spoken:
Provider: Spanish
Mo-Th - 8:00 AM - 7:00 PM
Fr - 8:00 AM - 5:00 PM
Brisco, Dustin R
Provider ID 002615629003
NPI: 1538243183
126 E Main St Ste C
Payson, AZ 85541
(928) 468-8907 EB, P, R
Callahan, Robin L
Provider ID 003182732003
NPI: 1669546958
126 E Main St Ste C
Payson, AZ 85541
(928) 468-8907 EB, P, R
Clauss, Kristin M
Provider ID 006595798002
NPI: 1972032977
126 E Main St Ste C
Payson, AZ 85541
(928) 471-3445 EB, P, R
Costello, Catherine M
Provider ID 007071512001
NPI: 1043777097
126 E Main St Ste C
Payson, AZ 85541
(928) 468-8907 EB, P, R
Hospital Affiliations:
Mayo Clinic Hospital
Generoso, Julie E
Provider ID 006918655002
NPI: 1609289594
126 E Main St Ste C
Payson, AZ 85541
(928) 471-3445 EB, P, R
Languages Spoken:
Provider: Spanish
Herzberg, David A
Provider ID 002410690003
NPI: 1013074210
126 E Main St Ste C
Payson, AZ 85541
(928) 468-8907 EB, P, R
Jean Philippe, Alethea D
Provider ID 005922843003
NPI: 1912382284
126 E Main St Ste C
Payson, AZ 85541
(928) 468-8907 EB, P, R
Hospital Affiliations:
Banner Univ Medical Cntr
Phoenix Campus
Kempton Physical Therapy
Provider ID 001703009001
NPI: 1568455608
1100 N Broad St Ste A
Globe, AZ 85501
(480) 807-9000 EB, IB, P, R
Languages Spoken:
Provider: Spanish
Staff: Spanish
Mo,We,Fr - 7:00 AM - 6:00 PM
Tu,Th - 7:00 AM - 12:00 PM
Kempton, James P
Provider ID 006468068001
NPI: 1508395492
1100 N Broad St Ste A
Globe, AZ 85501
(928) 961-1345 EB, IB, P, R
Ancillary Providers / Proveedores Auxiliares Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
121
CSAZ.18.999.01.9.017
Laukonen, Sabrina R
Provider ID 006129131002
NPI: 1497109086
126 E Main St Ste C
Payson, AZ 85541
(928) 471-3445 EB, P, R
Noack, Victoria D
Provider ID 002104286003
NPI: 1629528971
708 S Coeur D Alene Ln Ste B
Payson, AZ 85541
(928) 522-9410 EB, P, R
Nossek, Scott J
Provider ID 002662597001
NPI: 1861495210
405 W Main St Ste D
Payson, AZ 85541
(928) 474-0429 EB, IB, P, R
Mo-Fr - 7:30 AM - 5:00 PM
Web address: www.paysonphysicalt
herapy.com
Payson Physical Therapy
Provider ID 000788655001
NPI: 1194943423
405 W Main St Ste D
Payson, AZ 85541
(928) 474-0429 EB, IB, P, R
Languages Spoken:
Provider: Spanish
Mo-Fr - 7:30 AM - 5:00 PM
Sherrill, Christine C
Provider ID 000945044006
NPI: 1659552370
126 E Main St Ste C
Payson, AZ 85541
(928) 468-8907 EB, P, R
Tisoncik, Alyssa M
Provider ID 006900373001
NPI: 1932681343
126 E Main St Ste C
Payson, AZ 85541
(928) 468-8907 EB, P, R
Walden, Daniel H
Provider ID 006049347002
NPI: 1881066819
708 S Coeur D Alene Ln Ste B
Payson, AZ 85541
(928) 468-8610 EB, P, R
Skilled Nursing Facility / Centro
De Enfermería Especializada
Haven Of Globe
Provider ID 002126592001
NPI: 1467868075
1100 E Monroe St
Globe, AZ 85501
(928) 425-5721 EB, IB, P, PL, R
Languages Spoken:
Staff: Apache, Spanish
Heritage Health Care Center
Provider ID 001441622002
NPI: 1154368132
1300 E South St
Globe, AZ 85501
(928) 425-3118 EB, P, R
Payson Care Center
Provider ID 000792432001
NPI: 1033177308
107 E Lone Pine Dr
Payson, AZ 85541
(928) 474-6896 EB, P, R
Rim Country Hlth & Retirement
Community
Provider ID 000284378001
NPI: 1578568267
807 W Longhorn Rd
Payson, AZ 85541
(928) 474-1120 EB, P, R
Pinal
Dialysis Center / Centro De
Diálisis
Rcg Mammoth
Provider ID 002768419001
NPI: 1104928373
14786 S Hwy 77
Mammoth, AZ 85618
(520) 487-0150 EB, P, R
Physical Therapy / Fisioterapia
Desert Palms Physical Therapy
Catalina
Provider ID 003061804001
NPI: 1134308596
23 S Mcnab Pkwy
San Manuel, AZ 85631
(520) 385-4066 EB, P, R
Languages Spoken:
Provider: Spanish
Interpreter: Spanish
Nevada
Clark
Physical Therapy / Fisioterapia
Arizona - Pinal Ancillary Providers / Proveedores Auxiliares
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
122
CSAZ.18.999.01.9.017
Harward, Aaron A
Provider ID 005302116001
NPI: 1194121350
340 Falcon Ridge Pkwy Ste 500
Mesquite, NV 89027
(702) 346-3105 EB, P, R
Languages Spoken:
Staff: Spanish
Mo,We,Fr - 7:00 AM - 5:00 PM
Tu,Th - 9:00 AM - 5:00 PM
Johnson, Benjamin J
Provider ID 003135476001
NPI: 1548490196
340 Falcon Ridge Pkwy Ste 500
Mesquite, NV 89027
(702) 346-3105 EB, P, R
Languages Spoken:
Provider: Spanish
Staff: Spanish
Laird, Trenton E
Provider ID 006028882001
NPI: 1396101572
340 Falcon Ridge Pkwy Ste 500
Mesquite, NV 89027
(702) 397-6700 EB, P, R
Languages Spoken:
Staff: Spanish
Wakefield, Travis L
Provider ID 003023907001
NPI: 1013006469
1301 Bertha Howe Ave Ste 7
Mesquite, NV 89027
(702) 346-1899 EB, P, R
Languages Spoken:
Staff: Spanish
Utah
Kane
Home Health Agency / Agencia
De Cuidado De La Salud A
Domicilio
Zions Way Home Health &
Hospice
Provider ID 003612988002
NPI: 1588930705
217 E 300 S Ste 204
Kanab, UT 84741
(435) 688-0648 EB, P, R
Washington
Ambulatory Surgery Center /
Centro De Cirugía Ambulatoria
Coral Desert Surgery Center
Provider ID 002389460001
NPI: 1346205176
1490 E Foremaster Dr Bldg C
Saint George, UT 84790
(435) 674-5230 EB, P, R
South Main Surgery Center
Provider ID 001236542002
NPI: 1972528537
754 S Main St Ste 3
Saint George, UT 84770
(435) 628-2671 EB, P, R
Dialysis Center / Centro De
Diálisis
Liberty Dialysis St George
Provider ID 002975646002
NPI: 1861671422
624 S 1000 E Ste 101
Saint George, UT 84790
(435) 656-4596 EB, P, R
Home Health Agency / Agencia
De Cuidado De La Salud A
Domicilio
Zions Way Home Health &
Hospice
Provider ID 003612988002
NPI: 1588930705
1173 S 250 W Ste 401
Saint George, UT 84770
(435) 688-0648 EB, P, R
Orthotics/Prosthetics /
Ortesis/Prótesis
Hanger Prosthetics & Orthotics
Provider ID 006374534001
NPI: 1881768778
630 S 400 E Ste 102
Saint George, UT 84770
(435) 673-6449 EB, P, R
Physical Therapy / Fisioterapia
Blatter, Grant L
Provider ID 003566493001
NPI: 1558377309
1424 E Foremaster Dr Ste 120
Saint George, UT 84790
(435) 656-8800 EB, P, R
Hospital Affiliations:
Cedar City Hospital
Blatter, Grant L
Provider ID 003566493001
NPI: 1558377309
1449 N 1400 W Ste 21
Saint George, UT 84770
(435) 656-8800 EB, P, R
Hospital Affiliations:
Cedar City Hospital
Ancillary Providers / Proveedores Auxiliares Utah - Washington
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
123
CSAZ.18.999.01.9.017
Johnson, Richard J
Provider ID 001266136001
NPI: 1508844069
1490 E Foremaster Dr Ste 110
Saint George, UT 84790
(435) 652-4455 EB, P, R
Languages Spoken:
Staff: Spanish
Tomlinson, Stephen J
Provider ID 002444333001
NPI: 1043325715
1424 E Foremaster Dr Ste 120
Saint George, UT 84790
(435) 656-8800 EB, P, R
Tomlinson, Stephen J
Provider ID 002444333001
NPI: 1043325715
1449 N 1400 W Ste 21
Saint George, UT 84770
(435) 656-8800 EB, P, R
Utah - Washington Ancillary Providers / Proveedores Auxiliares
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
124
CSAZ.18.999.01.9.017
Arizona
Gila
Federally Qualified Health Care
Agency / Agencia De Salud
Federalmente Calificados
Canyonlands Health Care Globe
Integrated
Provider ID 006659800001
NPI: 1891169561
111 W Blake St Ste 12
Globe, AZ 85501
(928) 425-8158 EB, P, R
Federally Qualified Health Care Agency/Rural Health Clinic/ Agencia De Atención Médica Con CertificaciónFederal/Clínica De Salud Rural Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services
125
CSAZ.18.999.01.9.017
Arizona
Gila
Obstetrics & Gynecology /
Obstetricia Y Ginecología
Booth, Cynthia D, MD, (F), B
Banner Physician Specialists
Arizona
Provider ID 001898102002
NPI: 1215938022
117 E Main St Ste A100
Payson, AZ 85541
(928) 596-4700 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Payson Medical Center
Abrazo Arrowhead Campus
Abrazo Scottsdale Campus
Booth, Cynthia D, MD, (F), B
Banner Physician Specialists
Arizona
Provider ID 001898102002
NPI: 1215938022
120 E Main St Ste A
Payson, AZ 85541
(928) 596-4700 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Payson Medical Center
Abrazo Arrowhead Campus
Abrazo Scottsdale Campus
Bryan, Michael C, MD, (M), B
Cobre Valley Tonto Basin Clinic
Provider ID 003057119005
NPI: 1720278666
124 N Tewksbury Blvd
Young, AZ 85554
(928) 462-3435 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Cobre Valley Regional Medical
Center
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Bryan, Michael C, MD, (M), B
Cobre Valley Tonto Basin Clinic
Provider ID 003057119012
NPI: 1720278666
186 E Stephens Way
Tonto Basin, AZ 85553
(928) 479-2871 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Cobre Valley Regional Medical
Center
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Bryan, Michael C, MD, (M), B
The Az Partnership For
Immunization
Provider ID 003057119011
NPI: 1720278666
5515 S Apache Ave Ste 100
Globe, AZ 85501
(602) 288-7572 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Cobre Valley Regional Medical
Center
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Bryan, Michael C, MD, (M), B
Cobre Valley Tonto Basin Clinic
Provider ID 003057119007
NPI: 1720278666
5880 S Hospital Dr
Globe, AZ 85501
(928) 425-3247 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Cobre Valley Regional Medical
Center
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Bryan, Michael C, MD, (M), B
Cobre Valley Tonto Basin Clinic
Provider ID 003057119008
NPI: 1720278666
5886 S Hospital Dr
Globe, AZ 85501
(928) 425-7108 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Cobre Valley Regional Medical
Center
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Bryan, Michael C, MD, (M), B
Cobre Valley Tonto Basin Clinic
Provider ID 003057119009
NPI: 1720278666
5994 S Hospital Dr
Globe, AZ 85501
(928) 425-7108 EB, P, R
Languages Spoken:
Provider: Spanish
Arizona - Gila
Primary Care Obstetricians / Obstetras De Atención
Primaria
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
126
CSAZ.18.999.01.9.017
Ages: 0-99
Hospital Affiliations:
Cobre Valley Regional Medical
Center
Banner Del E Webb Medical
Center
Banner Boswell Medical Center
Daniels, Anthony E, MD, (M), B
Cobre Valley Regional Medical
Center
Provider ID 000051510001
NPI: 1326072901
124 N Tewksbury Blvd
Young, AZ 85554
(928) 462-3435 EB, P, R
Mo,We - 8:00 AM - 5:00 PM
Tu,Fr - 9:00 AM - 10:00 PM
Th - 9:00 AM - 4:30 PM
Ages: 0-99
Does Not Accept Male Patients
Hospital Affiliations:
Baptist Health Medical Ctr-hot
Spring Ct
Cobre Valley Regional Medical
Center
South Central Regional Med Ctr
Saline Hospital
Northside Hospital
Great River Medical Center
Lee, Katie, MD, (F)
North Country Healthcare
Provider ID 006852851001
NPI: 1801290457
708 Coeur D'alene Ste B
Payson, AZ 85541
(928) 468-8610 E, EB, IB, P, R
Ages: 12-99
Does Not Accept Male Patients
Salvino, Cora F, MD, (F), B
North Country Healthcare
Provider ID 002741329002
NPI: 1205881059
708 Coeur D'alene Ste B
Payson, AZ 85541
(928) 468-8610 E, EB, IB, P, R
Ages: 0-99
Does Not Accept Male Patients
Hospital Affiliations:
Wyoming Medical Center
Flagstaff Medical Center
Mountain View Regional Hospital
Tindall, William C, DO, (M)
Banner Physician Specialists
Arizona
Provider ID 002073220007
NPI: 1003929878
117 E Main St Ste A100
Payson, AZ 85541
(928) 596-4700 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Payson Medical Center
Summit Regional Medical Center
Banner Page Hospital
Tindall, William C, DO, (M)
Banner Physician Specialists
Arizona
Provider ID 002073220007
NPI: 1003929878
120 E Main St Ste A
Payson, AZ 85541
(928) 596-4700 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Payson Medical Center
Summit Regional Medical Center
Banner Page Hospital
Whitehair, Jennifer J, MD, (F), B
North Country Healthcare
Provider ID 005532549002
NPI: 1134236607
708 S Coeur D Alene Ln Ste B
Payson, AZ 85541
(928) 468-8610 EB, P, R
Ages: 0-99
Does Not Accept Male Patients
California
San Bernardino
Obstetrics & Gynecology /
Obstetricia Y Ginecología
London, Theodore D, MD, (M), B
Tri-State Ob-Gyn
Provider ID 001055572003
NPI: 1417950742
1600 Bailey Ave
Needles, CA 92363
(928) 704-2229 EB, P, R
Ages: 0-99
Hospital Affiliations:
Colorado River Medical Center
Western Arizona Regional
Medical
Valley View Medical Center
Utah
Washington
Obstetrics & Gynecology /
Obstetricia Y Ginecología
Primary Care Obstetricians / Obstetras De AtenciónPrimaria California - San Bernardino
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
127
CSAZ.18.999.01.9.017
Benham, Brady N, MD, (M), B
Valley Obstetrics & Gynecology
Provider ID 002520448005
NPI: 1952380685
295 S 1470 E # 200
Saint George, UT 84790
(435) 628-1662 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Brown, Coby T, MD, (M)
Valley Obstetrics & Gynecology
Provider ID 005356471003
NPI: 1083907059
295 S 1470 E Ste 200
Saint George, UT 84790
(435) 628-1662
Ages: 0-99
Hospital Affiliations:
Dixie Regional Medical Center
Primary Care Obstetricians / Obstetras De Atención
Primaria
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
128
CSAZ.18.999.01.9.017
Arizona
Gila
Advanced Practice Registered
Psychiatric Nurse Practitioner /
Enfermera Psiquiátrica Titulada
En Práctica Avanzada
Albarracin, Janette M, MS, (F)
Community Bridges
Provider ID 003349731002
NPI: 1982913034
5734 E Hope Lane
Globe, AZ 85501
(928) 425-2415
Ages: 0-99
Areas of Expertise: Provider Led
Integrated Care
Coordination,telemental Health
Capability
Albarracin, Janette M, MS, (F)
Community Bridges
Provider ID 003349731002
NPI: 1982913034
803 W Main St
Payson, AZ 85541
(928) 468-0022 EB, P, R
Ages: 0-99
Areas of Expertise: Provider Led
Integrated Care
Coordination,telemental Health
Capability
Dery, Jessica L, MA, (F)
Southwest Behavioral Services
Provider ID 003535301002
NPI: 1043561624
404 W Aero Dr
Payson, AZ 85541
(928) 474-3303 EB, P, R
Ages: 0-99
Areas of Expertise: Telemental
Health Capability
Ekman, John K, FNP, (M)
Southeastern Arizona Behavioral
Health S
Provider ID 002455301001
NPI: 1194722256
996 N Broad St Ste 10
Globe, AZ 85501
(928) 425-2185 EB, P, R
Ages: 0-99
Hospital Affiliations:
Mt Graham Regional Medical
Cente
Areas of Expertise: Serious Mental
Illness
Fargas Rodriguez, Arnaldo, MA,
(M)
Southwest Behavioral Services
Provider ID 003624150001
NPI: 1689831794
404 W Aero Dr
Payson, AZ 85541
(928) 474-3303 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Green, Christie A, NP, (F)
Community Bridges
Provider ID 006702307002
NPI: 1982153649
803 W Main St
Payson, AZ 85541
(928) 468-0022 EB, P, R
Ages: 0-99
Areas of Expertise: Provider Led
Integrated Care Coordination
Hatfield, Laura, MS, (F)
Southwest Behavioral Services
Provider ID 003632708001
NPI: 1205178613
404 W Aero Dr
Payson, AZ 85541
(928) 474-3303 EB, P, R
Ages: 0-99
Kazaka, Katharine A, MS, (F)
Community Bridges
Provider ID 003226614001
NPI: 1386889517
5734 E Hope Lane
Globe, AZ 85501
(928) 425-2415
Ages: 0-99
Areas of Expertise: Buprenorphine
Mat,provider Led Integrated Care
Coordination,telemental Health
Capability
Kazaka, Katharine A, MS, (F)
Community Bridges
Provider ID 003226614001
NPI: 1386889517
803 W Main St
Payson, AZ 85541
(928) 468-0022 EB, P, R
Ages: 0-99
Areas of Expertise: Buprenorphine
Mat,provider Led Integrated Care
Coordination,telemental Health
Capability
Manco, Sarah, NP, (F)
Mountain Health And Wellness
Provider ID 003450057001
NPI: 1396907598
2250 Hwy 60, Suite I
Globe, AZ 85501
(928) 740-2803 EB, P, R
Ages: 0-99
Behavioral Health Providers / Proveedores De Salud Mental Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
129
CSAZ.18.999.01.9.017
Mccarvell, Kathleen A, NP, (F)
Horizon Health And Wellness
Provider ID 003179911003
NPI: 1154500981
415 W Baseline Spur
Globe, AZ 85501
(928) 402-9297 EB, P, R
Cultural Competency: Y
Ages: 0-99
Hospital Affiliations:
Tacoma General Allenmore
Padilla, Shannon L, MS, (F)
Health Group Providers LLC
Provider ID 003505938002
NPI: 1871840520
1100 E Monroe St
Globe, AZ 85501
(602) 734-5664 EB, IB, P, PL, R
Ages: 0-99
Areas of Expertise: Serious Mental
Illness
Pupillo, Andrea M, NP, (F)
Southwest Behavioral Services
Provider ID 005528898001
NPI: 1265812135
404 W Aero Dr
Payson, AZ 85541
(928) 474-3303 EB, P, R
Ages: 0-99
Rankovic, Alecia, MSN, (F)
Community Bridges
Provider ID 003360055001
NPI: 1205129384
5734 E Hope Lane
Globe, AZ 85501
(928) 425-2415
Ages: 0-99
Areas of Expertise: Chem
Depend/sub Abuse/sud,provider Led
Integrated Care
Coordination,telemental Health
Capability
Rankovic, Alecia, MSN, (F)
Community Bridges
Provider ID 003360055001
NPI: 1205129384
803 W Main St
Payson, AZ 85541
(928) 468-0022 EB, P, R
Ages: 0-99
Areas of Expertise: Chem
Depend/sub Abuse/sud,provider Led
Integrated Care
Coordination,telemental Health
Capability
Sexton, Alicia A, MS, (F)
Southwest Behavioral Services
Provider ID 006592681001
NPI: 1932627395
404 W Aero Dr
Payson, AZ 85541
(928) 474-3303 EB, P, R
Ages: 0-99
Staires, Marilyn A, MS, (F)
Community Bridges
Provider ID 003232652003
NPI: 1962724799
5734 E Hope Lane
Globe, AZ 85501
(928) 425-2415
Ages: 0-99
Areas of Expertise: Chem
Depend/sub Abuse/sud,provider Led
Integrated Care
Coordination,telemental Health
Capability
Vaughn, Kimara M, MS, (F)
Community Bridges
Provider ID 003046303001
NPI: 1003068727
5734 E Hope Lane
Globe, AZ 85501
(928) 425-2415
Ages: 0-99
Areas of Expertise: Provider Led
Integrated Care
Coordination,telemental Health
Capability
Vaughn, Kimara M, MS, (F)
Community Bridges
Provider ID 003046303001
NPI: 1003068727
803 W Main St
Payson, AZ 85541
(928) 468-0022 EB, P, R
Ages: 0-99
Areas of Expertise: Provider Led
Integrated Care
Coordination,telemental Health
Capability
Young, Jillian E, MS, (F)
Community Bridges
Provider ID 006882835002
NPI: 1134614324
803 W Main St
Payson, AZ 85541
(928) 468-0022 EB, P, R
Ages: 0-99
Zak, Svetlana V, MS, (F)
Mountain Health And Wellness
Provider ID 003182856033
NPI: 1386831832
2250 Hwy 60 Ste I
Globe, AZ 85501
(928) 402-8032 EB, P, R
Languages Spoken:
Provider: Russian
Ages: 0-99
Arizona - Gila Behavioral Health Providers / Proveedores De Salud Mental
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
130
CSAZ.18.999.01.9.017
Nurse Prac - Mental Health /
Enfermera Especialista - Salud
Mental
Manco, Sarah, NP, (F)
Mountain Health And Wellness
Provider ID 003450057001
NPI: 1396907598
2250 Hwy 60, Suite I
Globe, AZ 85501
(928) 740-2803 EB, P, R
Ages: 0-99
Physician Assistant-Behavioral /
Comportamiento Del Asistente
Médico
Madsen, Roman K, PA, (M)
Mountain Health And Wellness
Provider ID 005903304001
NPI: 1750784617
2250 Hwy 60 Ste I
Globe, AZ 85501
(928) 402-8032 EB, P, R
Ages: 0-99
Madsen, Roman K, PA, (M)
Mountain Health And Wellness
Provider ID 005903304001
NPI: 1750784617
415 W Baseline Spur
Globe, AZ 85501
(928) 402-9297 EB, P, R
Ages: 0-99
Mcdonald, Jennifer P, PA, (F)
Mountain Health And Wellness
Provider ID 005607787019
NPI: 1144605171
2250 Hwy 60 Ste I
Globe, AZ 85501
(928) 402-8032 EB, P, R
Ages: 0-99
Mcminn, Sylvia E, PA, (F)
Health Group Providers LLC
Provider ID 002897426006
NPI: 1063631760
1100 E Monroe St
Globe, AZ 85501
(602) 734-5664 EB, IB, P, PL, R
Cultural Competency: Y
Ages: 0-99
Areas of Expertise: Serious Mental
Illness
Sarko, Genowefa H, PA, (F)
Southwest Behavioral Services
Provider ID 002167829002
NPI: 1225139322
404 W Aero Dr
Payson, AZ 85541
(928) 474-3303 EB, P, R
Languages Spoken:
Provider: Polish, Russian
Ages: 0-99
Professional Counselor /
Consejero Profesional
Appleby Kittle, Carrie L, MA, (F)
Community Bridges
Provider ID 007132860001
NPI: 1871867085
803 W Main St
Payson, AZ 85541
(928) 468-0022 EB, P, R
Ages: 0-99
Benitez, Jose, LPC, (M)
North Country Healthcare
Provider ID 007160389001
NPI: 1619233624
126 E Main St Ste B
Payson, AZ 85541
(928) 468-8610 EB, P, R
Ages: 0-99
Castle, Roxanne L, MA, (F)
Pathways Of Az
Provider ID 006575885001
NPI: 1700219318
Foster Care Only Provider
Payson, AZ 85541
(540) 710-6085
Ages: 0-99
Davenport, Lori C, MA, (F)
Southwest Behavioral Services
Provider ID 006797188001
NPI: 1689171654
404 W Aero Dr
Payson, AZ 85541
(928) 474-3303 EB, P, R
Ages: 0-99
Edgerly, Bennett, PHD, (M)
North Country Healthcare
Provider ID 006556272001
NPI: 1114442316
708 S Coeur D Alene Ln Ste B
Payson, AZ 85541
(928) 468-8610 EB, P, R
Ages: 0-99
Fargas Rodriguez, Arnaldo, MA,
(M)
Southwest Behavioral Services
Provider ID 003624150001
NPI: 1689831794
404 W Aero Dr
Payson, AZ 85541
(928) 474-3303 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Behavioral Health Providers / Proveedores De Salud Mental Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
131
CSAZ.18.999.01.9.017
Hollingsworth, Randolph S, MS,
(M)
Southeastern Arizona Behavioral
Health S
Provider ID 003101693001
NPI: 1285871855
996 N Broad St Ste 10
Globe, AZ 85501
(928) 425-2185 EB, P, R
Cultural Competency: Y
Ages: 0-99
Areas of Expertise: Chem
Depend/sub Abuse/sud
Long, Kristen L, LPC, (F)
Southwest Behavioral Services
Provider ID 006165876001
NPI: 1275808883
404 W Aero Dr
Payson, AZ 85541
(928) 474-3303 EB, P, R
Ages: 0-99
Martorana, Diana, MA, (F)
Community Bridges
Provider ID 006527441001
NPI: 1629516786
803 W Main St
Payson, AZ 85541
(928) 468-0022 EB, P, R
Ages: 0-99
Areas of Expertise: Provider Led
Integrated Care Coordination
Mccartney Belcher, Susie, MA,
(F)
Pathways Of Az
Provider ID 006577385001
NPI: 1255497038
Foster Care Only Provider
Payson, AZ 85541
(540) 710-6085
Ages: 0-99
Park, Lori A, MA, (F)
Horizon Health And Wellness
Provider ID 003285325002
NPI: 1053561431
2250 Hwy 60 Ste I
Globe, AZ 85501
(928) 402-8032 EB, P, R
Ages: 0-99
Park, Lori A, MA, (F)
Horizon Health And Wellness
Provider ID 003285325002
NPI: 1053561431
415 W Baseline Spur
Globe, AZ 85501
(928) 402-9297 EB, P, R
Ages: 0-99
Todd, Rock A, LPC, (M)
North Country Healthcare
Provider ID 003226853001
NPI: 1205073582
708 S Coeur D Alene Ln Ste B
Payson, AZ 85541
(928) 468-8610 EB, P, R
Ages: 0-99
Wilhelm, Jared M, MA, (M)
Southeastern Arizona Behavioral
Health S
Provider ID 002539998001
NPI: 1326130634
996 N Broad St Ste 10
Globe, AZ 85501
(928) 425-2185 EB, P, R
Ages: 0-99
Wilkinson, Linda Z, MA, (F)
Southwest Behavioral Services
Provider ID 006725130001
NPI: 1679886188
404 W Aero Dr
Payson, AZ 85541
(928) 474-3303 EB, P, R
Ages: 0-99
Willis, Chad R, MA, (M)
Community Bridges
Provider ID 006977740001
NPI: 1184190324
803 W Main St
Payson, AZ 85541
(928) 468-0022 EB, P, R
Ages: 0-99
Psychiatric Nurse / Enfermera
Psiquiátrica
Dery, Jessica L, MA, (F)
Southwest Behavioral Services
Provider ID 003535301002
NPI: 1043561624
404 W Aero Dr
Payson, AZ 85541
(928) 474-3303 EB, P, R
Ages: 0-99
Areas of Expertise: Telemental
Health Capability
Psychiatry / Psiquiatría
Franz, Douglas M, MD, (M), B
University Physician Specialists
LLC
Provider ID 002920276005
NPI: 1053582221
807 S Ponderosa St
Payson, AZ 85541
(928) 474-3222 EB, P, R
Ages: 0-99
Hospital Affiliations:
Banner Del E Webb Medical
Center
Banner Univ Medical Cntr
Phoenix Campus
Banner Estrella Medical Center
Banner Goldfield Medical Center
Arizona - Gila Behavioral Health Providers / Proveedores De Salud Mental
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
132
CSAZ.18.999.01.9.017
Mccall, Scott C, MD, (M), B
Southwest Behavioral Services
Provider ID 000418611002
NPI: 1083625883
404 W Aero Dr
Payson, AZ 85541
(928) 474-3303 EB, P, R
Languages Spoken:
Provider: Spanish
Web address: www.sbhservices.org
Ages: 0-99
Sadr, Payam M, MD, (M), B
Community Bridges
Provider ID 003170808002
NPI: 1043479249
5734 E Hope Lane
Globe, AZ 85501
(928) 425-2415
Languages Spoken:
Provider: German, Persian,
Spanish
Ages: 0-99
Hospital Affiliations:
Valleywise Health
Areas of Expertise: Provider Led
Integrated Care Coordination
Sadr, Payam M, MD, (M), B
Community Bridges
Provider ID 003170808002
NPI: 1043479249
803 W Main St
Payson, AZ 85541
(928) 468-0022 EB, P, R
Languages Spoken:
Provider: German, Persian,
Spanish
Ages: 0-99
Hospital Affiliations:
Valleywise Health
Areas of Expertise: Provider Led
Integrated Care Coordination
Tharani, Shalini, MD, (F)
Southwest Behavioral Services
Provider ID 003490817001
NPI: 1386841252
404 W Aero Dr
Payson, AZ 85541
(928) 474-3303 EB, P, R
Ages: 0-99
Areas of Expertise: Telemental
Health Capability
Zamanian, Arash, MD, (M)
Southwest Behavioral Services
Provider ID 003433868005
NPI: 1184924904
404 W Aero Dr
Payson, AZ 85541
(928) 474-3303 EB, P, R
Ages: 0-99
Psychiatry Group / Grupo De
Psiquiatría
Canyonlands Community Health
Care Vista
Provider ID 006161966001
NPI: 1619945904
111 W Blake St Ste 12
Globe, AZ 85501
(928) 425-8158 EB, P, R
Ages: 0-99
Caring Connections Special Needs
LLC
Provider ID 005687547002
NPI: 1255517587
600 E State Highway 260
Payson, AZ 85541
(520) 732-9524
Ages: 0-99
Community Bridges
Provider ID 006193503001
NPI: 1649426909
5734 E Hope Lane
Globe, AZ 85501
(928) 425-2415
Languages Spoken:
Provider: Spanish
Ages: 0-99
Areas of Expertise: Buprenorphine
Mat,chem Depend/sub
Abuse/sud,opioid Treatment
Service,serious Mental
Illness,substance Abuse
Professional,telemental Health
Capability
Community Bridges
Provider ID 006193503001
NPI: 1649426909
5734 Hope Ln
Globe, AZ 85501
(928) 425-2415 EB, P, R
Languages Spoken:
Provider: Spanish
Staff: Spanish
Mo-Fr - 8:00 AM - 4:00 PM
Web address: https://communitybrid
gesaz.org/
Ages: 0-99
Areas of Expertise: Buprenorphine
Mat,chem Depend/sub
Abuse/sud,opioid Treatment
Service,serious Mental
Illness,substance Abuse
Professional,telemental Health
Capability
Behavioral Health Providers / Proveedores De Salud Mental Arizona - Gila
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
133
CSAZ.18.999.01.9.017
Community Bridges
Provider ID 006193503001
NPI: 1649426909
5734 Hope Ln Ste 2
Globe, AZ 85501
(928) 425-2415 EB, P, R
Languages Spoken:
Provider: Spanish
Ages: 0-99
Areas of Expertise: Buprenorphine
Mat,chem Depend/sub
Abuse/sud,opioid Treatment
Service,serious Mental
Illness,substance Abuse
Professional,telemental Health
Capability
Community Bridges
Provider ID 006193503001
NPI: 1649426909
803 W Main St
Payson, AZ 85541
(928) 468-0022 EB, P, R
Languages Spoken:
Provider: Spanish
Staff: Spanish
Web address: https://communitybrid
gesaz.org/
Ages: 0-99
Areas of Expertise: Buprenorphine
Mat,chem Depend/sub
Abuse/sud,opioid Treatment
Service,serious Mental
Illness,substance Abuse
Professional,telemental Health
Capability
Horizon Health And Wellness
Provider ID 005839333001
NPI: 1659308989
2250 Hwy 60 Ste I
Globe, AZ 85501
(928) 402-8032 EB, P, R
Ages: 0-99
Areas of Expertise: Naltrexone
Injectiible Mat,serious Mental
Illness,telemental Health Capability
Horizon Health And Wellness
Provider ID 005839333001
NPI: 1659308989
415 W Baseline Spur
Globe, AZ 85501
(928) 402-9297 EB, P, R
Ages: 0-99
Areas of Expertise: Naltrexone
Injectiible Mat,serious Mental
Illness,telemental Health Capability
Mountain Health And Wellness
Provider ID 005836729001
NPI: 1164729745
2250 Hwy 60 Ste I
Globe, AZ 85501
(928) 402-8032 EB, P, R
Ages: 0-99
Mountain Health And Wellness
Provider ID 005836729001
NPI: 1164729745
415 W Baseline Spur
Globe, AZ 85501
(928) 402-9297 EB, P, R
Ages: 0-99
Pathways Of Az
Provider ID 005663721004
NPI: 1275845646
Foster Care Only Provider
Pine, AZ 85544
(540) 710-6085
Ages: 0-99
Psychology Specialists
Provider ID 002265487001
NPI: 1053368605
621 S Fifth St
Globe, AZ 85501
(309) 706-3190 E, EB, IB, P, R
Ages: 0-99
Southwest Behavioral Services
Provider ID 005692338001
NPI: 1104030980
111 W Cedar Ln Ste A
Payson, AZ 85541
(928) 468-8055 E, EB, IB, P, R
Ages: 0-99
Southwest Behavioral Services
Provider ID 005692338001
NPI: 1104030980
111 W Cedar Ln Ste B
Payson, AZ 85541
(928) 468-8055 EB, P, R
Ages: 0-99
Southwest Behavioral Services
Provider ID 005692338001
NPI: 1104030980
404 W Aero Dr
Payson, AZ 85541
(928) 474-3303 EB, P, R
Ages: 0-99
Psychology / Psicología
Livesay, Lynette, PHD, (F)
Southwest Behavioral Services
Provider ID 003761821001
NPI: 1972819688
404 W Aero Dr
Payson, AZ 85541
(928) 474-3303 EB, P, R
Ages: 0-99
Vaughn, Kimara M, MS, (F)
Community Bridges
Provider ID 003046303001
NPI: 1003068727
5734 E Hope Lane
Globe, AZ 85501
(928) 425-2415
Ages: 0-99
Areas of Expertise: Provider Led
Integrated Care
Arizona - Gila Behavioral Health Providers / Proveedores De Salud Mental
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
134
CSAZ.18.999.01.9.017
Coordination,telemental Health
Capability
Vaughn, Kimara M, MS, (F)
Community Bridges
Provider ID 003046303001
NPI: 1003068727
803 W Main St
Payson, AZ 85541
(928) 468-0022 EB, P, R
Ages: 0-99
Areas of Expertise: Provider Led
Integrated Care
Coordination,telemental Health
Capability
Willcoxon, Ronald L, PHD, (M)
Southwest Behavioral Services
Provider ID 000784562001
NPI: 1003947698
404 W Aero Dr
Payson, AZ 85541
(928) 474-3303 EB, P, R
Ages: 0-99
Social Worker - Licensed /
Trabajador Social - Licenciada
Fiscus, Georgina L, MA, (F)
Southeastern Arizona Behavioral
Health S
Provider ID 003274926001
NPI: 1780621862
996 N Broad St Ste 10
Globe, AZ 85501
(928) 425-2185 EB, P, R
Ages: 0-99
Grudowski, Rebecca, MA, (F)
Southwest Behavioral Services
Provider ID 006715575001
NPI: 1386145803
404 W Aero Dr
Payson, AZ 85541
(928) 474-3303 EB, P, R
Ages: 0-99
Hoffman, Christine M, MA, (F)
Southwest Behavioral Services
Provider ID 003767496001
NPI: 1558657296
404 W Aero Dr
Payson, AZ 85541
(928) 474-3303 EB, P, R
Ages: 0-99
Park, Lori A, MA, (F)
Horizon Health And Wellness
Provider ID 003285325002
NPI: 1053561431
2250 Hwy 60 Ste I
Globe, AZ 85501
(928) 402-8032 EB, P, R
Ages: 0-99
Park, Lori A, MA, (F)
Horizon Health And Wellness
Provider ID 003285325002
NPI: 1053561431
415 W Baseline Spur
Globe, AZ 85501
(928) 402-9297 EB, P, R
Ages: 0-99
Pinal
Advanced Practice Registered
Psychiatric Nurse Practitioner /
Enfermera Psiquiátrica Titulada
En Práctica Avanzada
Mccarvell, Kathleen A, NP, (F)
Horizon Health And Wellness
Provider ID 003179911003
NPI: 1154500981
980 E Mt Lemmon Road
Oracle, AZ 85623
(480) 983-0065 EB, P, R
Cultural Competency: Y
Ages: 0-99
Hospital Affiliations:
Tacoma General Allenmore
Schrodetzki, Candice, MS, (F)
Horizon Health And Wellness
Provider ID 006789617004
NPI: 1235630427
980 E Mt Lemmon Road
Oracle, AZ 85623
(520) 896-6019 EB, P, R
Cultural Competency: Y
Ages: 0-99
Wise, Elise C, NP, (F)
Horizon Health And Wellness
Provider ID 003323308004
NPI: 1245265917
23 S Mcnab Pkwy
San Manuel, AZ 85631
(520) 896-9240 EB, P, R
Ages: 0-99
Areas of Expertise: Naltrexone
Injectiible Mat,serious Mental
Illness
Wise, Elise C, NP, (F)
Horizon Health And Wellness
Provider ID 003323308004
NPI: 1245265917
980 E Mt Lemmon Road
Oracle, AZ 85623
(520) 896-9240 EB, P, R
Ages: 0-99
Areas of Expertise: Naltrexone
Injectiible Mat,serious Mental
Illness
Behavioral Health Providers / Proveedores De Salud Mental Arizona - Pinal
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
135
CSAZ.18.999.01.9.017
Physician Assistant-Behavioral /
Comportamiento Del Asistente
Médico
Madsen, Roman K, PA, (M)
Mountain Health And Wellness
Provider ID 005903304001
NPI: 1750784617
980 E Mt Lemmon Road
Oracle, AZ 85623
(520) 896-9240 EB, P, R
Ages: 0-99
Mcdonald, Jennifer P, PA, (F)
Mountain Health And Wellness
Provider ID 005607787016
NPI: 1144605171
980 E Mt Lemmon Road
Oracle, AZ 85623
(520) 896-6019 EB, P, R
Ages: 0-99
Nelson, Thomas J, PA, (M)
Horizon Health And Wellness
Provider ID 004987683004
NPI: 1508293713
980 E Mt Lemmon Road
Oracle, AZ 85623
(520) 896-6019 EB, P, R
Ages: 0-99
Professional Counselor /
Consejero Profesional
Park, Lori A, MA, (F)
Horizon Health And Wellness
Provider ID 003285325002
NPI: 1053561431
980 E Mt Lemmon Road
Oracle, AZ 85623
(520) 896-9240 EB, P, R
Ages: 0-99
Psychiatry Group / Grupo De
Psiquiatría
Banner University Medical Group
Provider ID 000118542004
NPI: 1508809427
23 S Mcnab Pkwy
San Manuel, AZ 85631
(520) 385-2234 EB, P, R
Ages: 0-99
Horizon Health And Wellness
Provider ID 005839333001
NPI: 1659308989
23 S Mcnab Pkwy
San Manuel, AZ 85631
(520) 896-9240 EB, P, R
Ages: 0-99
Areas of Expertise: Naltrexone
Injectiible Mat,serious Mental
Illness,telemental Health Capability
Horizon Health And Wellness
Provider ID 005839333001
NPI: 1659308989
980 E Mt Lemmon Road
Oracle, AZ 85623
(520) 896-6019 EB, P, R
Ages: 0-99
Areas of Expertise: Naltrexone
Injectiible Mat,serious Mental
Illness,telemental Health Capability
Mountain Health And Wellness
Provider ID 005836729001
NPI: 1164729745
23 S Mcnab Pkwy
San Manuel, AZ 85631
(520) 896-9240 EB, P, R
Ages: 0-99
Mountain Health And Wellness
Provider ID 005836729001
NPI: 1164729745
980 E Mt Lemmon Rd
Oracle, AZ 85623
(520) 896-6019 EB, P, R
Ages: 0-99
Psychology / Psicología
Aldridge, Sarah M, CP, (F)
Sun Life Family Health Ct
Provider ID 006430293001
NPI: 1679004667
1870 W American Ave
Oracle, AZ 85623
(520) 896-2092 EB, P, R
Sa - 8:00 AM - 12:00 PM
Ages: 0-99
Social Worker - Licensed /
Trabajador Social - Licenciada
Horn, Rebecca J, MS, (F)
Sun Life Family Health Center
Provider ID 003514294003
NPI: 1295087740
1870 W American Way
Oracle, AZ 85623
(520) 896-2092 E, EB, IB, P, R,
RE, S, T
Cultural Competency: Y
Ages: 0-99
Areas of Expertise: Hiv/aids/arc
Horn, Rebecca J, MS, (F)
Sun Life Family Health Center
Provider ID 003514294003
NPI: 1295087740
23 S Mcnab Pkwy
San Manuel, AZ 85631
(520) 385-2234 EB, P, R
Cultural Competency: Y
Ages: 0-99
Areas of Expertise: Hiv/aids/arc
Arizona - Pinal Behavioral Health Providers / Proveedores De Salud Mental
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
136
CSAZ.18.999.01.9.017
Park, Lori A, MA, (F)
Horizon Health And Wellness
Provider ID 003285325002
NPI: 1053561431
980 E Mt Lemmon Road
Oracle, AZ 85623
(520) 896-9240 EB, P, R
Ages: 0-99
Robison, Cecelia M, MS, (F)
Sun Life Family Health Ct
Provider ID 005202743001
NPI: 1275938540
1870 W American Way
Oracle, AZ 85623
(520) 896-2092 E, EB, IB, P, R,
RE, S, T
Languages Spoken:
Staff: Spanish
Cultural Competency: Y
Ages: 0-99
Robison, Cecelia M, MS, (F)
Sun Life Family Health Ct
Provider ID 005202743001
NPI: 1275938540
23 S Mcnab Pkwy
San Manuel, AZ 85631
(520) 385-2234 EB, P, R
Sa - 8:00 AM - 12:00 PM
Cultural Competency: Y
Ages: 0-99
Behavioral Health Providers / Proveedores De Salud Mental Arizona - Pinal
= Wheelchair Accessible = Provider is within one (1) mile of public transportation B = Board CertifiedP = Parking EB = Exterior Building R = Restroom E = Exam Room T = Exam Table/Scale/ChairsG = Gurneys & Stretchers PL = Portable Lifts RE = Radiologic Equipment S = Signage & Documents
= Telehealth Services = 24-hour
137
CSAZ.18.999.01.9.017
Arizona
Gila
Community Mental Health
Center / Centro De Salud Mental
En La Comunidad
Community Bridges Hope Ln
Provider ID 007018610001
NPI: 1093960304
5734 Hope Ln Ste 2
Globe, AZ 85501
(928) 425-2415 EB, P, R
Community Bridges Payson
Provider ID 006939441001
NPI: 1548416514
803 W Main St
Payson, AZ 85541
(928) 468-0022 EB, P, R
Payson Outpatient Service
Provider ID 007041477001
NPI: 1548709173
803 W Main St
Payson, AZ 85541
(480) 631-7566 EB, P, R
Psychiatric Hospital / Instituto De
Salud Mental
Horizon Health And Wellness
Provider ID 002763959002
NPI: 1821489527
415 W Baseline Spur
Globe, AZ 85502
(480) 983-0571 EB, P, R
Areas of Expertise: Detoxification
Southwest Behavioral Health
Services
Provider ID 007135577001
NPI: 1255448833
8985 W Stageline Rd
Payson, AZ 85541
(928) 468-2399 EB, P, R
Areas of Expertise: Sa Residential
Arizona - Gila Behavioral Health Facilities / Servicios De Salud Mental
Unless noted, all providers have regular office hours (M-F, 8 am- 5pm) and accept new patients. All providersare proficient in English unless otherwise noted. These provider are AHCCCS Complete (Medicaid + CRS
Fully Integrated + CRS Partially Integrated only providers.
138
CSAZ.18.999.01.9.017
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CSAZ.18.999.01.9.017
AAbbott, Brandon H, DO.......................... 35Abdo, Joseph G, MD. ............................. 60Ahern, Naquita...................................... 121Ahmad, Nazish, DO................................ 62Albarracin, Janette M, MS.................... 129Aldridge, Sarah M, CP. ........................ 136Alexander, Roberto B, PA.............. 100, 99Ali, Sheiba, NP. ...................................... 90Alkhatib, Basil J, MD. ............................ 54Alten, Kimberly B, FNP. ........................ 32Alvarez-Corona, April C, MD................ 39Andersen, Nisha D, NP................. 108, 109Anderson, Phan T, PA. ........................... 40Andrade, Oscar E, MD. .......................... 32Appleby Kittle, Carrie L, MA. ............. 131Arias, Sylvia K, NP. ............................... 90Askari, Ali A, MD. ..................... 52, 54, 63Aslam, Kaleem, MD............................... 68Aston, Nathan W, PA. .......................... 113Atalla, Jamal, MD................................... 69Austin, Glen D, DO. ............................... 39Aviant Hospice Gila. ............................ 120
BBadhwar, Shruti, DO. ............................. 89Bahu, Marwan M, MD. .......................... 54Bakall, Benjamin B, MD. ....................... 93Balakrishnan, Radhakrishnan B, MD. .... 69Ballou, Elise W, PA.............................. 100Balraj, Praveen C, MD. ........................ 104Banner Home Care Arizona. ................ 120Banner Payson Medical Center. ............. 31Banner University Medical Group. ...... 136Barakat, Mark R, MD. ............................ 93Barry, Courtney J, NP....................... 44, 46Bartholomew, Patricia A, NP. ................ 36Barton, Deborah D, NP......................... 109Barton, Scott D, MD............................... 49Bartow, Brian E. ................................... 121Bashas. .................................................. 118Bean, Thomas S, PA............................... 51Bechtold, Lance L, MD. ......................... 69Beecham, Christine A........................... 120Beenfield, Scott, PA. .............................. 41Belen, Cary D, DO. ................................ 69Benedict, Kelly A, MD........................... 98Benham, Brady N, MD......................... 128Benitez, Jose, LPC................................ 131Benoit, Martin J, MD.............................. 95Berbos, Zachary J, MD........................... 93Bernstein, Desmond J. .......................... 121Bheemanathini, Praveen, MD................. 63Bi, Sucai, MD. .................................. 62, 92Bibb, Javier M, MD.......................... 69, 70Biehn, Jeffrey L, DO. ............................. 95Bingham, Ryan D, MS. .......................... 91Bishop, Karen, NP. ................................. 36Bista, Amar B, MD................................. 70
Black, Cameron T, MD. ....................... 108Blanc, Carol A. ..................................... 120Blatter, Grant L..................................... 123Bludworth, Lesley M............................ 121Boon, Roberta E, NP. ............................. 36Boorman, David C, MD. ...................... 108Booth, Cynthia D, MD. ........................ 126Bottiglione, Richard G, MD. .................. 57Bowman, Jonathan C, MD. .................... 49Brisco, Dustin R. .................................. 121Brown, Coby T, MD............................. 128Brown, Delana P, FNP. .......................... 58Brown, Hosea E, MD. .......................... 105Brown, Mark S, PA. ............................... 41Brown, Melissa L, NP. ........................... 46Bryan, Joseph S, MD.............................. 93Bryan, Michael C, MD. ................ 126, 127Bucchireddigari, Lokeswari, FNP. ......... 58Bueno, Damaso S, MD. .......................... 70Burdick, Jeremy K, NP........................... 36Burstein, David M, MD.......................... 70Burton, Stephen K, DPM...................... 114Buxton-Fattohy, Suzan S, MD. .............. 71Byrne, Timothy J, DO. ........................... 54
CCallahan, Kimberly A, NP...................... 36Callahan, Robin L................................. 121Campbell, Chad, PA. .............................. 41Campbell, Douglas J, MD. ..................... 33Campton, Carley R, NP. ......................... 58Canyonlands Community Health Care
Vista...................................................... 133Canyonlands Health Care Globe
Integrated. ............................................. 125Canyonlands Hlthcr-Globe. .................... 34Capampangan, Dan J, MD...................... 89Caring Connections Special Needs LLC.
.............................................................. 133Carlile, Maranda S, NP................... 36, 109Carlson, Joshua N, MD................. 105, 110Carpenter, Derek B, PA.......................... 48Carstens, Sarah J, MD. ........................... 63Castle, Roxanne L, MA. ....................... 131Celani, Lacey B, NP. .............................. 36Chadha, Manpreet K, MD. ..................... 92Chalasani, Rajendra, MD........................ 71Challa, Suresh, MD. ............................... 64Chamberlain, Howard L, MD................. 50Chandra-Shekharan, Binoy, MD. ........... 35Channis, Basel, MD................................ 71Chase, Robyn N, DO. ............................. 64Chase, Steven P, MD............................ 111Chaudhary, Asad J, MD. .................. 64, 71Chen, Ang, MD. ..................................... 72Cherukuri, Madhavagopal V, MD.......... 54Christensen, Bryt A, MD.............. 112, 113Christiansen, Sheena A, FNP. ................ 58Chugh, Tarun, MD.................................. 72
Chukwurah, Chinwe N, MD................... 45Clark, Randy R, MD............................. 110Clauss, Kristin M.................................. 121Cobbs, Brian W, FNP. ............................ 58Cobre Valley Pharmacy........................ 118Cobre Valley Regional Medical Center.. 31Community Bridges...................... 133, 134Community Bridges Hope Ln............... 138Community Bridges Payson. ................ 138Cooper, Heather A, PA........................... 41Cooper, Randal, MD............................... 33Copper State Home Health. .................. 120Coral Desert Surgery Center................. 123Corrigan, Teresa A, FNP. ....................... 58Cortez, Andrew J, DO. ........................... 72Costello, Catherine M........................... 121Cox, Brandon R, PA. .................... 106, 113Crane, Heather A, NP. ............................ 37Crawford, John T, DO. ........................... 45Croft, Scott T, MD.................................. 96Cumbria, Wayne M, MD............ 64, 72, 73Currier, Samantha L, NP. ....................... 46Curry, Irene S, FNP. ............................... 44Cvs Pharmacy #. ................................... 118
DDahl, Katharine C, MD........................... 73Daniels, Anthony E, MD. ..................... 127Dardy, Sandra K, NP. ............................. 46Davenport, Lori C, MA. ....................... 131Davis, Jessica R, FNP............................. 58Day, Trevor J, DO. ............................... 108De Long, Michael J, MD. ....................... 73De Retana, Natalija, NP.......................... 91Demack, Michael K, PA......................... 41Dery, Jessica L, MA. .................... 129, 132Desai, Sachin N, MD........................ 73, 74Desert Palms Physical Therapy Catalina.
.............................................................. 122Desouza, Stephen A, MD. ...................... 93Dickson, Alysha N, PA......................... 113Dixie Regional Medical Center. ............. 31Dixon, Megan B, MD. ............................ 74Doxey, G P, MD. .................................. 111Draper, Joann, NP................................... 37Druschel, Michael J, MD........................ 33
EEckhardt, Jody, FNP............................... 58Edelman, Steven R, FNP. ....................... 91Edgerly, Bennett, PHD. ........................ 131Ekman, John K, FNP. ..................... 129, 58Engelman, Holly J, FNP. ........................ 58Ethington, Roger, OD........................... 117Evans, Robert T, DPM. ........................ 102
FFader, Paul F, MD. ................................. 33Fadia, Amit J, MD. ................................. 74Falke, Sharon L, NP. .............................. 37Fargas Rodriguez, Arnaldo, MA. . 129, 131
Index
140
CSAZ.18.999.01.9.017
Fiscus, Georgina L, MA. ...................... 135Fisler, Rita E, MD................................... 57Foulger, Jordan, PA. ............................... 41Franz, Douglas M, MD......................... 132Freeburg, Dominic D, PA..................... 100Freeman, Monica, NP............................. 37Frieden, Derek L, MD. ......................... 112Frys Food And Drug............................. 118
GGalitsky, Anthony, MD. ......................... 60Gandhi, Zahabia T, MD.................... 49, 50Garber, Jason E, MD. ........................... 109Garcia, Matilda C, MD. .......................... 40Gardner, Kent E, MD. .......................... 111Gatchalian, Raul A, MD. ........................ 74Gawelko, Gary E, PA. ............................ 41Generoso, Julie E. ................................. 121Genoa Healthcare, LLC........................ 118Geyer, Katelyn A, DO. ........................... 45Gleason, Philip E, MD............................ 99Goldenberg, David T, MD...................... 94Goodman, Brian W, DO. ........................ 33Goodman, Darenie, MD. ........................ 97Goodman, Herbert D, MD...................... 97Gordon, Alan J, MD. .............................. 94Goswami, Puja, MD. .............................. 75Green, Christie A, NP..................... 129, 37Green, Michael R, MD. ........................ 111Griffin, Brandie D, FNP. ........................ 91Griffin, Kelly D, NP. ........................ 44, 46Grover, Rajinder S, MD. .................. 61, 62Grudowski, Rebecca, MA. ................... 135Gurley, Mindy R, NP............................ 109Gwinn, Karen S, FNP. ............................ 32
HHachem, Hassan A, MD. ........................ 75Halepota, Maqbool A, MD. .............. 62, 64Hall, Hugh R, DPM. ............................. 103Halter, Mitchell R, MD........................... 97Hanger Prosthetics & Orthotics. ........... 123Hanger Prosthetics & Orthotics West... 121Hanna, Abboud, MD. ............................. 75Harward, Aaron A. ............................... 123Hatfield, Laura, MS. ............................. 129Haven Of Globe.................................... 122Heaton, Rex, NP. .................................... 50Heritage Health Care Center................. 122Herzberg, David A................................ 121Hill, Jennifer L, MD. .............................. 52Hillstead, Alan P, MD. ................. 112, 113Ho, Warren Reyes, MD. ................... 65, 76Hoffman, Christine M, MA. ................. 135Hoffsten, Pilar M, FNP........................... 44Hollingshead, Bryson J, DO. .................. 49Hollingsworth, Randolph S, MS........... 132Holsten, Raymond L, MD. ..................... 33Horizon Health And Wellness.134, 136,
138
Horn, Rebecca J, MS. ................... 136, 137Horne, Susan C, MD............................... 60Hospice Compassus. ............................. 120Howlader, Anjuman A, MD. .................. 76Hsieh, Stephanie S, MD. ........................ 98Hubbard, Jonathan P, DO. ...................... 50Hunt, Judith A, MD. ............................... 40Hutzler, Rachel L, FNP. ......................... 58
IIdeal Therapies. .................................... 120Islam, Shahedul, MD. ............................. 35
JJackson, Jeffrey, OD............................. 117Jacob, Joseph R, MD. ........................... 111Jaffe, William M, DO. ...................... 52, 55Jain, Neal, MD.................................. 40, 52Jarrell, Christopher, NP. ......................... 37Jazayeri, Sadra S, MD. ........................... 57Jean Philippe, Alethea D. ..................... 121Jebaily, Nicholas X, MD. ....................... 55Jennings, Cameron S, MD............ 108, 109Jensen, David L, DO............................... 33Jimenez, Angela C, MD. ........................ 40Johnson, Benjamin J. ............................ 123Johnson, Benjamin J, PT. ..................... 106Johnson, Dayne A, PA.......................... 114Johnson, Richard J. ............................... 124Jones, Holly R....................................... 120Jones, Jamison C, MD. ......... 105, 107, 108Jose, Emily, NP. ..................................... 91Joseph, Mark W, MD. ............................ 98Judd, Lois M, NP.................................... 37
KKane County Hospital. ........................... 31Kaonohi, Leighton K, PA. .................... 114Kartoumah, Almutaz B, MD. ................. 76Kazaka, Katharine A, MS..................... 129Kc's Home Health Care. ....................... 120Keen, Brent L, MD. ................................ 33Kelly, Lawrence J, MD........................... 96Kempton Physical Therapy. ................. 121Kempton, James P. ............................... 121Khan, Yulia K, MD. ............................... 57Kigundu, Jacqueline, NP. ....................... 37Kim, Jin K, MD. ..................................... 76Kimble, Guatemala D, NP................ 46, 47King, Shellese A, DDS. ........................ 116Kitchen, Dallon R, PA.......................... 100Klein, Neal A, MD. .......................... 55, 67Klein-Mascia, Kendra A, MD. ............... 94Klug, Ronald G, NP................................ 91Knecht, Richard D, MD.......................... 33Koppal, Theresa D, PA......................... 100Krause, Lonny D, NP. .................. 105, 109Krieble, Barry F, MD. ............................ 77Kulkarni, Sanjay B, MD. ........................ 65Kwong, Henry M, MD. .......................... 94
LLaird, Trenton E. .................................. 123Langford, Martin B, MD. ........... 61, 65, 92Lassen, Judith M, NP.............................. 37Laukonen, Sabrina R. ........................... 122Laurel, Edgardo R, MD. ......................... 77Ledesma, Linda-Michelle, DO. .............. 60Lee, Katie, MD. .................................... 127Lee-Iannotti, Joyce K, MD. .................... 90Leopold, Peter S, DO........................ 65, 77Lewis, Wesley K, DPM........................ 103Lex, Stephen F, MD. ............................ 102Liao, Tina Y, MD. .................................. 48Liberty Dialysis St George. .................. 123Lien, Yeong-Hau H, MD........................ 78Lietzow, Rebecca J, NP. ................... 37, 38Lindner, Clare J, MD.............................. 99Lindner, Elizabeth J, FNP................. 59, 91Lindstrom, Rebecca T........................... 120Liu, Zhao, MD. ....................................... 78Livesay, Lynette, PHD. ........................ 134Logan, Joy L, MD................................... 78Loli, Akil I, MD................................ 55, 68London, Theodore D, MD. ................... 127Long, Kristen L, LPC. .......................... 132Lord, Ron K, MD. ........................ 106, 110Lunders, Shannon E, PA......................... 41Lunt, Bryce C, MD. ................................ 50
MMadsen, Roman K, PA. ................ 131, 136Maki, Peter C, MD. .......................... 55, 68Manco, Sarah, NP......................... 129, 131Mandap, Marissa P, DMD.................... 116Manor, Cynthia, NP................................ 47Martin, Cynthia E, MD..................... 35, 40Martorana, Diana, MA.......................... 132Marupakula, Vidyasagargoud, MD. ....... 65Maxwell, Krissie, NP.............................. 32Mc Bride, Wade J, PA. ......................... 100Mcbride, Zachariah, PA.................... 41, 42Mccall, Scott C, MD............................. 133Mccartney Belcher, Susie, MA............. 132Mccarvell, Kathleen A, NP........... 130, 135Mcdevitt, Kyle K, NP. ............................ 47Mcdonald, Jennifer P, PA.131, 136, 100,
105Mcelroy, Crystal L, FNP. ....................... 91Mcguffin, Martha R, NP......................... 38Mclaws, Ivan D, DPM.......................... 103Mcleod, Robert J, PA. .......................... 100Mcminn, Sylvia E, PA.................. 131, 100Mcpherson, Bruce A, PA.............. 106, 114Mcweeney, Colleen, NP. ........................ 38Melde, Richard A, MD. .......................... 35Memon, Abdul Q, MD. ........ 53, 56, 66, 68Mercado-Depaz, Disnilda L, PA. ..... 48, 49Merrill, Jarilynne B, MD. ....................... 59Michels, Alan P, MD.............................. 36
Index
141
CSAZ.18.999.01.9.017
Miles, Jenny W, FNP.............................. 59Millbourn, Lorna J, NP........................... 91Miller, Elizabeth G, NP. ......................... 38Mishler, Rick E, MD. ............................. 78Mix, Michelle, MD................................. 53Monson, Melissa M, NP. ........................ 47Montano, Gilbert J, FNP................... 59, 91Morales, Alejandro, MD......................... 79Morales, Ralph E, MD............................ 56Morgan, John M, MD. ...................... 53, 56Morse, Suzanne, NP. .................. 38, 91, 98Mortenson, Duane S, PA. ............... 42, 100Mountain Health And Wellness. .. 134, 136Mugo, Patti W, MD. ............................... 34Mumick, Guneet K, MD......................... 79Munoz, Luis A, MD. .............................. 60Mustafa, Esmat M, MD. ......................... 79Myers, Brad A, MD.............................. 109Myers, Janet, FNP. ................................. 59
NNabha, Anil, MD. ................................... 80Nasim, Kashif, MD................................. 66Nayyar, Deepak, MD.............................. 45Nelson, Gloriajean, NP........................... 38Nelson, Thomas J, PA. ................. 136, 105Neumann, Thomas V, MD. .................... 80Newland, Anne M, MD. ......................... 36Neyra, Nilda R, MD. .............................. 80Ngo-Truong, Lisa L, MD. ...................... 66Nguyen, Dat D, MD. ...................... 103, 66Nica, Romanita D, MD..................... 80, 81Nichols, Cameron L, PA......................... 42Nichols, Deborah, FNP..................... 32, 38Nichols, Logan R, PA............................. 49Nilson, Wendell T, MD. ......................... 50Nimer, Lynn R, MD. ............................ 108Noack, Victoria D................................. 122North Country Hlth-Payson.............. 34, 35Nossek, Scott J...................................... 122
OO'brien, Aaron M, MD. ................ 106, 111O'brien, Mary Jane, FNP. ....................... 59Ochieng, Judith M, NP. .......................... 47Olson, Loyd B, MD. ............................... 60
PPacker, Jeffrey, DO. ............................... 81Padilla, Shannon L, MS........................ 130Palo Verde Hospital................................ 31Paolini, David J, MD. ........................... 104Parekh, Shehzad M, MD......................... 81Park, Lori A, MA.......... 132, 135, 136, 137Parker, Ronald D, MD............................ 59Parry, Ami, NP. .................................... 110Parry, Scott A, MD. .............. 106, 108, 111Parry, Todd R, MD. ...................... 106, 111Patalinghug, Neal P, MD........................ 34Pathways Of Az. ................................... 134Patil, Arun S, MD. ............................ 53, 56
Payne, Jeremy R, MD............................. 90Payson Care Center. ............................. 122Payson Outpatient Service.................... 138Payson Physical Therapy...................... 122Peifer, Peter B, PA.................................. 42Pendleton, Gus C, MD............................ 50Perveze, Zeeshan, MD............................ 81Petersen, Colby B, PA. ......................... 114Peterson, Richard N, PA....................... 100Peterson, Ryan T, DPM........ 107, 114, 115Philip, Selin, FNP. .................................. 47Pierce, Donald L, NP.............................. 38Pleasant Valley Comm Medi. ................. 44Pokharel, Milap, MD. ....................... 81, 82Porter, Andrew R, PA........................... 101Porter, Levi, PA. ............................. 42, 101Powell, Andrew B, DPM...................... 115Preferred Homecare. ............................. 120Psychology Specialists. ........................ 134Pupillo, Andrea M, NP. ........................ 130Pyles, Ryan M, DO................................. 66
QQueior, Paul, PA..................................... 42Quesada, Nikki C, NP............................. 47Quigley, Jack B, MD. ........................... 102
RRaja, Rubina A, MD. .............................. 36Rakkar, Amol N, MD. ................ 62, 92, 93Ramat, Shanna, NP................................. 38Ramos, Alberto X, MD..................... 63, 66Rankovic, Alecia, MSN........................ 130Raposas, Stella C, MD............................ 48Raskin, David A, MD. ...................... 67, 82Rcg Globe. ............................................ 120Rcg Mammoth. ..................................... 122Reber, Keith R, DPM. .......................... 115Reber, Leon K, DPM.................... 107, 115Rector, Tamara H, FNP. ......................... 32Reddy, Rahul K, MD.............................. 94Reyes, Carlos, MD.................................. 82Richards, Bradley D, PA. ................. 42, 43Richards, Ray S, MD............................ 115Riesenman, Paul J, MD. ....................... 104Rim Country Hlth & Retirement
Community. .......................................... 122Risser, Christian F, MD.......................... 94Rivero, Alejandro J, MD. ................. 82, 83Robb, Wendy A, NP. .............................. 92Robey, Jean T, MD................................. 83Robison, Cecelia M, MS....................... 137Robison, Glen N, DPM......................... 103Rodgers Herington, Debra A, NP. .... 44, 48Rogers, Scott T, PA. ............................. 101Rokkam, Vamsi, MD.............................. 83Rooney, Holly E, MD............................. 34Root, Bradley D, DO. ........................... 113Root, Eric J, DO. .................................... 49Root, Max R, MD. ................................ 113
Rust, Jeffery, PA................................... 101S
Saadat, Sharareh, MD................. 67, 83, 84Sacks, Paul, MD. .................................... 84Sadr, Payam M, MD. ............................ 133Safeway Pharmacy #1536. ................... 118Saha, Deepa J, FNP. ............................... 59Sahani, Mandeep M, MD. ................ 60, 84Saifee, Mustufa T, MD. ................ 107, 115Salehi-Rad, Reza, DO............................. 84Salim, Muhammad M. .......................... 120Salim, Muhammad M, MD................... 103Salvatore, Theresa S, NP. ....................... 38Salvino, Cora F, MD............................. 127Sangave, Amit A, MD. ........................... 95Sanna, Sathish, MD. ............................... 85Santos, Peter W, DO............................... 85Sarko, Genowefa H, PA. .............. 131, 101Savage, Colleen M, NP........................... 38Sawyer, Steven J, MD. ........................... 61Scales, Krystal, NP. ................................ 38Schmidt, Heidi M, PA. ........................... 43Scholzen, David T, PA. ........................ 101Schrodetzki, Candice, MS. ................... 135Scott, Diane M, PA............................... 101Sepich, Dustin J, MD.............................. 97Sexton, Alicia A, MS............................ 130Shackelford, Laura, NP. ......................... 38Shakil, Bassam S, MD............................ 85Shanah, Sara, NP. ................................... 38Shank, Lawrence P, MD......................... 97Sheftel, Scott N, MD. ....................... 57, 58Sherrill, Christine C. ............................. 122Shimamoto, Sam R, MD......................... 52Shuja, Khawaja F, MD. .......................... 67Sikuyayenga, Mutende J, MD. ............... 67Silveira, Gina, NP............................. 38, 39Singh, Harnath, MD.......................... 85, 86Smith, Gary A, MD. ............................... 34Smith, Lary J, DPM...................... 107, 115Smith, Michael C, PA............................. 43Song, Miran J, MD. ................................ 40Sorenson, David S, PA. ........................ 101South Main Surgery Center. ................. 123Southwest Behavioral Health Services. 138Southwest Behavioral Services. ........... 134Speakman, J Jared, MD. ....................... 109Staires, Marilyn A, MS......................... 130Stallings, Shantay, PA. ......................... 102Stanley, Lisa A, NP. ............................... 32Stevenson, Troy G, PA. ................ 102, 105Stoit, Sarah, NP. ..................................... 39Stover, Linda C, FNP. ............................ 59Stratford, C K, MD. ................................ 50Strickland, Suzanne L, PA.................... 102Stucki, Sean J, PA................................. 114Sullivan, Rachel, NP............................... 92Sumar, Riyaz A, MD. ....................... 56, 68
Index
142
CSAZ.18.999.01.9.017
Sun Life Family - Oracle. ....................... 45Sun Life Family Health Center............. 119Sun Life Family Health Ct...................... 45Sun Life Family-San Manue................... 45Sutak, Alan K, MD. .............................. 111Swaminathan, Ariv, MD......................... 86Swanson, Jennifer, PA.......................... 102Swidinsky, Teddi, MD............................ 61Swift, Travis J, PA................................ 114
TTani, Jason C, MD.................................. 97Taylor, Kimberly E, FNP. ...................... 48Tew, Debbie M. .................................... 121Thakkar, Snehal G, MD.................... 62, 63Tharani, Shalini, MD. ........................... 133Thema Health Services. ........................ 120Thomas, Robert A, MD. ......................... 95Thompson, Coralee G, MD. ................... 45Thompson, Joseph C, DO....................... 34Tindall, William C, DO. ....................... 127Ting, Steven C, MD................................ 86Tisoncik, Alyssa M............................... 122Todd, Rock A, LPC. ............................. 132Tomlinson, Stephen J. .......................... 124Tong, Shumei, MD. ................................ 49Torzala, Daniel T, MD. .......................... 90Toth, Sharon L, FNP............................... 59Truong, Frank, MD................................. 34Tuli, Ajay, MD. ...................... 46, 104, 105Tunuguntla, Rashmi, DO........................ 48Turner, Adam C, PA............................... 43Turney-Shaw, Jean R, NP....................... 39Twiggs, Jerry D, MD.............................. 51
UUdall, John H, MD. ................................ 99Uddin, Muhammad A, MD............... 86, 87Ungar, Scott A, DO. ............................... 87
VVakil, Hiva, MD. .............................. 53, 57Van Gils, Carl C, DPM......................... 115Vaughan, Andrew H, MD..................... 112Vaughn, Kimara M, MS. .............. 130, 135Veltkamp, Claire, FNP. .......................... 39Vigil, Lynne A, FNP............................... 32
WWade, Laura, MD. .................................. 34Wakefield, Travis L. ............................. 123Walden, Daniel H. ................................ 122Walgreens #6533. ................................. 118Walker, Bradley, OD. ........................... 117Walmart Pharmacy 10-1334. ................ 118Walmart Pharmacy 10-1369. ................ 118Wang, Shouwen, MD. ............................ 87Watabe, Jayson, PA. ............................... 43Watkins, Katherine, NP. ......................... 39Watson, Fanae F, NP. ............................. 39Watson, Joy M, PA................................. 43Welch, Matthew J, MD........................... 95
Wheeler, John C, MD. ............................ 97White, Andrew C, PA........................... 102White, Shari J, PA. ................................. 43Whitehair, Jennifer J, MD. ................... 127Whittman, David T, MD......................... 87Wilhelm, Jared M, MA......................... 132Wilkinson, Linda Z, MA. ..................... 132Willcoxon, Ronald L, PHD. ................. 135Williamson, Pamela, NP......................... 39Willis, Chad R, MA.............................. 132Wilson, Robin D, FNP...................... 44, 48Wise, Elise C, NP. ........................ 135, 136Witt, Norina, MD.................................... 40Wombold, Leroy D, DO. ........................ 61Woods, Russell, OD. ............................ 117Wurtz, Eric S, PA. ................................ 102Wyma, Mark, PA.............................. 43, 44
XXie, Bing, FNP. ...................................... 48
YYancy, Holly M, DO. ............................. 90Yoder, Paul T, MD. ................................ 34Young, Jillian E, MS. ........................... 130Yu, Stephanie P, PA. .............................. 44
ZZaharia, Valentin, MD............................ 88Zak, Svetlana V, MS............... 130, 131, 92Zamanian, Arash, MD. ......................... 133Zar, Tausif, MD. ..................................... 88Zhao, Hui J, MD. .................................... 88Zhao, Joseph, MD................................... 89Ziemianski, Matthew C, MD.................. 95Zions Way Home Health & Hospice.123,
123Zmrzel, Sara, NP. ................................... 39Zou, Lixian, MD..................................... 89
Index
143
CSAZ.18.999.01.9.017
Member Services
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CSAZ.18.999.01.9.017