GUADALUPE MEDICAL GROUP LLC - NPI 1629547104 - General Practice in Tempe, AZ

Q: What is Guadalupe Medical Group LLC's NPI number?

The NPI number for Guadalupe Medical Group LLC is 1629547104. It was assigned to this organization in the NPPES registry on November 14, 2018.

Q: What is Guadalupe Medical Group LLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

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About Guadalupe Medical Group Llc NPPES

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

GUADALUPE MEDICAL GROUP LLC (NPI 1629547104) is a healthcare organization registered as a general practice in Tempe, Arizona and active in the NPI registry since November 2018. The organization lists Michael Cormier, Owner, as its authorized official.

NPPES Registry Identity

NPI1629547104

Entity TypeOrganization

Primary Taxonomy208D00000X

Legal Business NameGUADALUPE MEDICAL GROUP LLC

Location Address1855 E GUADALUPE RD STE 112Tempe, AZ 85283-3269

Mailing Address4432 N Miller Rd Ste 102Scottsdale, AZ 85251-3697 · (480) 306-7227 · Fax (480) 306-7238

Phone(480) 839-8552

Fax(480) 926-2260

Organization SubpartNo

Authorized OfficialMichael CormierOwner · (480) 926-7800

Enumeration DateNovember 14, 2018

Last NPPES UpdateFebruary 12, 20245 updates tracked since enumeration

NPPES CertifiedFebruary 12, 2024

✔ NPI 1629547104 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Also ListedChiropractorTaxonomy 111N00000X

Also ListedPhysical Medicine & RehabilitationTaxonomy 208100000X

Also ListedPhysical TherapistTaxonomy 225100000X

Also ListedPhysician AssistantTaxonomy 363A00000X

1855 E GUADALUPE RD STE 112, Tempe, AZ 85283

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medical Equipment Supplier Medicare DMEPOS 2

Medicare supplier enrollment and the product categories Guadalupe Medical Group, LLC carries, from the Medicare DMEPOS supplier directory.

Guadalupe Medical Group, LLC

DMEPOS supplier · Tempe, AZ

✔

Accepts Medicare assignment

Guadalupe Medical Group, LLC agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20451797

Medicare Participant SinceNovember 27, 2018

Supplier Location1855 E Guadalupe Rd Ste 112Tempe, AZ 85283

Phone(480) 306-7227

Provider TypePhysician Assistant · Multi-Specialty - Physician

Medicare Product Categories

Orthoses: Prefabricated (Non-Custom Fabricated)

Met pads, Heel pads, Heel spur pads

Orthoses: Off-The-Shelf

Met pads, Heel pads, Heel spur pads

Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 8

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

DR. JORDAN TENNANT D.C.

Chiropractor