OCOTILLO INTERNAL MEDICINE ASSOCIATES - NPI 1154543650

Q: What is Ocotillo Internal Medicine Associates's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hospice and Palliative Medicine, with taxonomy code 207RH0002X.

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About Ocotillo Internal Medicine Associates NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OCOTILLO INTERNAL MEDICINE ASSOCIATES (NPI 1154543650) is a healthcare organization registered as a hospice and palliative medicine in Chandler, Arizona and active in the NPI registry since May 2007. The organization holds 2 active CLIA laboratory certificates and lists Jonathan W Hackenyos, Partner, as its authorized official.

NPPES Registry Identity

NPI1154543650

Entity TypeOrganization

Primary Taxonomy207RH0002X

Legal Business NameOCOTILLO INTERNAL MEDICINE ASSOCIATES

Location Address245 S DOBSON RDChandler, AZ 85224-6577

Mailing Address245 S Dobson RdChandler, AZ 85224-6577 · (480) 895-5870 · Fax (480) 895-0573

Phone(480) 895-5870

Fax(480) 895-0573

Organization SubpartNo

Authorized OfficialJonathan W HackenyosPartner · (480) 895-5870

Enumeration DateMay 3, 2007

Last NPPES UpdateNovember 11, 2008

✔ NPI 1154543650 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Hospice and Palliative MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207RH0002X

Definition

An internal medicine physician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team to maximize quality of life while addressing physical, psychological, social and spiritual needs of both patient and family throughout the course of the disease, through the dying process, and beyond for the family. This specialist has expertise in the assessment of patients with advanced disease; the relief of distressing symptoms; the coordination of interdisciplinary patient and family-centered care in diverse venues; the use of specialized care systems including hospice; the management of the imminently dying patient; and legal and ethical decision making in end-of-life care.

245 S DOBSON RD, Chandler, AZ 85224

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Other Identifiers 1

Medicare ID-Type UnspecifiedZ79712AZ · Group Id#

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 03D1029765

Ocotillo Internal Medicine Associates · Chandler, AZ

Active · expires Aug 22, 2026

CLIA Number03D1029765

Laboratory TypePhysician Office

Certificate Effective DateAugust 23, 2024

Certificate Expiration DateAugust 22, 2026

Laboratory DirectorCheryl W. Maurice

Laboratory Phone(480) 895-5870

Laboratory LocationOcotillo Internal Medicine Associates245 S Dobson Rd, Chandler, AZ 85224

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Waiver 03D2080388

Ocotillo Internal Medicine Associates · Gilbert, AZ

Active · expires Jul 6, 2028

CLIA Number03D2080388

Laboratory TypePhysician Office

Certificate Effective DateJuly 7, 2026

Certificate Expiration DateJuly 6, 2028

Laboratory DirectorJonathan W. Hackenyos

Laboratory Phone(480) 895-5870

Laboratory LocationOcotillo Internal Medicine Associates3503 S Mercy Rd, Gilbert, AZ 85297

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BROOKE M LEE PA-C

Physician Assistant