YAVAPAI CARDIAC SURGERY
NPI 1619169950
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Prescott, AZ

Q: What is Phoenix Cardiac Surgery's NPI number?

The NPI number for Phoenix Cardiac Surgery is 1619169950. It was assigned to this organization in the NPPES registry on August 10, 2007. The provider is doing business as Yavapai Cardiac Surgery.

Q: What is Phoenix Cardiac Surgery's specialty?

The primary specialty registered for this NPI is Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.

Active since August 10, 2007

811 AINSWORTH DR, SUITE 109, PRESCOTT, AZ 86301(928) 771-5595 Get Directions Write a Review

NPPES record last updated: January 7, 2015. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Yavapai Cardiac Surgery NPPES

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

YAVAPAI CARDIAC SURGERY (NPI 1619169950) is a healthcare organization registered as a thoracic surgery (cardiothoracic vascular surgery) in Prescott, Arizona and active in the NPI registry since August 2007. The organization lists Pierre R Tibi, Owner, as its authorized official.

NPPES Registry Identity

NPI1619169950

Entity TypeOrganization

Primary Taxonomy208G00000X

Legal Business NamePHOENIX CARDIAC SURGERY

Location Address811 AINSWORTH DR, SUITE 109Prescott, AZ 86301-1687

Mailing Address3131 E Clarendon Ave, Suite 102Phoenix, AZ 85016-7069 · (602) 253-9168

Phone(928) 771-5595

Organization SubpartNo

Authorized OfficialPierre R TibiOwner · (602) 253-9168

Enumeration DateAugust 10, 2007

Last NPPES UpdateJanuary 7, 2015

✔ NPI 1619169950 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic Physicians

Taxonomy Code208G00000X

Definition

A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.

811 AINSWORTH DR, Prescott, AZ 86301

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Other Names 1

Doing Business AsYavapai Cardiac Surgery

Other Identifiers 2

Medicare PINZ118122

Medicaid938632AZ

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Yavapai Cardiac Surgery is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 11 clinicians reassign Medicare billing to Yavapai Cardiac Surgery, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians by Medicare Specialty 3

Thoracic Surgery6

Cardiac Surgery3

Nurse Practitioner2

Clinicians, nearest first (11)

Nicole Sydow, M.D.

Thoracic Surgery

NPI 1255598900

1215 N BEAVER ST SUITE 203
Flagstaff, AZ 86001

(928) 773-2150

✔ PECOS✔ Accepts Medicare65 mi

Orazio Amabile, M.D.

Thoracic Surgery

NPI 1992993927

3131 E CLARENDON AVE 102
Phoenix, AZ 85016

(602) 253-9168