DR. ANDREW EMAD HANNA D.D.S., M.D.
NPI 1992024871
Oral & Maxillofacial Surgery in San Antonio, TX
NPI Status: Active since May 18, 2010
Contact Information
4499 MEDICAL DR STE 190
SAN ANTONIO, TX
ZIP 78229
Phone: (210) 614-3915
Fax: (210) 614-5234
- Individual
- Male
- Years of Experience 16
- Oral & Maxillofacial Surgery
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About ANDREW HANNA
This page provides the complete NPI Profile along with additional information for Andrew Hanna, a provider established in San Antonio, Texas with a medical specialization in Oral & Maxillofacial Surgery and more than 16 years of experience. The healthcare provider is registered in the NPI registry with number 1992024871 assigned on May 2010. The practitioner's primary taxonomy code is 204E00000X with license number R0011 (TX). The provider is registered as an individual and his NPI record was last updated 3 years ago.
- NPI
- 1992024871
- Provider Name
- DR. ANDREW EMAD HANNA D.D.S., M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 4499 MEDICAL DR STE 190 SAN ANTONIO, TX 78229
- Location Phone
- (210) 614-3915
- Location Fax
- (210) 614-5234
- Mailing Address
- 4499 MEDICAL DR STE 190 SAN ANTONIO, TX 78229
- Mailing Phone
- (210) 614-3915
- Mailing Fax
- (210) 614-5234
- Medical School Name
- OTHER
- Graduation Year
- 2010
- Is Sole Proprietor?
- No
- Enumeration Date
- 05-18-2010
- Last Update Date
- 07-21-2022
- Code Navigator
Location Map
Secondary Locations
- 4502 Medical Dr
San Antonio, TX 78229
(210) 358-4000
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Oral & Maxillofacial Surgery
- Taxonomy Code
- 204E00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- R0011
- License State
- TX
- Taxonomy Description
- Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
---|---|---|---|---|
1 | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Gold 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + Adult Dental + Vision - HMO
- Gold 3 Advanced: Aetna network + $0 walk-in clinic + Adult Dental + Vision - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + Adult Dental + Vision - HMO
- Silver S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 + Adult Dental+Vision - HMO
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Choice Bronze HSA (QualChoice) - POS
- Complete Gold - PPO
- Complete Gold + Vision + Adult Dental - PPO
- Complete Silver (QualChoice) - POS
- Connected Silver - PPO
- Connected Silver (QualChoice) - POS
- Connected Silver (QualChoiceLife) - PPO
- Connected Silver + Vision + Adult Dental - PPO
- Elite Bronze - PPO
- Elite Bronze + Vision + Adult Dental - PPO
- Elite Gold (QualChoice) - POS
- Elite Gold (QualChoiceLife) - PPO
- Everyday Bronze - PPO
- Everyday Bronze + Vision + Adult Dental - PPO
- Everyday Gold - PPO
- Everyday Gold + Vision + Adult Dental - PPO
- Everyday Silver (QualChoiceLife) - PPO
- Focused Silver - PPO
- Focused Silver + Vision + Adult Dental - PPO
- Standard Expanded Bronze - PPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Complete Silver - EPO
- Complete Silver + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
- Elite Bronze - PPO
- Elite Bronze + Vision + Adult Dental - PPO
- Elite Gold - PPO
- Elite Gold + Vision + Adult Dental - PPO
- Everyday Bronze - PPO
- Everyday Bronze + Vision + Adult Dental - PPO
- Everyday Gold - PPO
- Everyday Gold + Vision + Adult Dental - PPO
- Focused Silver - PPO
- Focused Silver + Vision + Adult Dental - PPO
- Standard Expanded Bronze - PPO
- Standard Expanded Bronze + Vision + Adult Dental - PPO
- Standard Gold - PPO
- Standard Gold + Vision + Adult Dental - PPO
- Standard Silver - PPO
- Anthem Bronze Essential 6500 HSA (+ Incentives) - HMO
- Anthem Bronze Essential 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Essential 9200 (+ Incentives) - HMO
- Anthem Bronze Essential 9200 Adult Dental/Vision (+ Incentives) - HMO
- Anthem Bronze Essential POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Essential POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Pathway 6900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Bronze Pathway 9200 (+ Incentives) - EPO
- Anthem Bronze Pathway HMO 7450 for HSA - HMO
- Anthem Bronze Pathway HMO 7500 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway HMO 9200 ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway HMO 9200 Adult Dental & Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
- Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Priority/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Priority/Lean HSA (+ Incentives) - HMO
- Anthem Bronze Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Catastrophic Pathway 9200 (+ Incentives) - EPO
- Bronze Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Bronze Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Bronze Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Bronze Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Bronze Standard - HMO
- Catastrophic Standard - HMO
- Gold Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Gold Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Gold Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Gold Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Gold Standard - HMO
- Silver Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Silver Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Silver Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Silver Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Silver Standard - HMO
- Bronze Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Bronze Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Bronze Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Bronze Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Bronze Standard - HMO
- Catastrophic Standard - HMO
- Gold Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Gold Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Gold Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Gold Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Gold Standard - HMO
- Silver Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Silver Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Silver Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Silver Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Silver Standard - HMO
- BEST Life Superior Dental Plan - PPO
- BEST Essential Basic Dental Plan - PPO
- BEST Life Essentail Basic Dental Plan - PPO
- BEST Life Essentail Value Dental Plan - PPO
- BEST Life Essental Value Dental Plan - PPO
- BEST Life Essential Basic Dental - PPO
- BEST Life Essential Basic Dental Plan - PPO
- BEST Life Essential Basic Dental - PPO
- BEST Life Essential Basic Dental Plan - PPO
- BEST Life Essential Vakue Dental Plan - PPO
- BEST Life Essential Value Dental Plan - PPO
- BEST Life Essential Value Dental - PPO
- BEST Life Essential Value Dental Plan - PPO
- BEST Life Preferred Dental Plan - PPO
- BEST Life Preferred Dental - PPO
- BEST Life Preferred Dental Plan - PPO
- BEST Life Preferred Dental plan - PPO
- BEST Life Superior Dental - PPO
- BEST Life Superior Dental Plan - PPO
- BEST Life Superior Dental Plan - PPO
- Blue HSA Bronze - PPO
- Blue Protect - PPO
- Blue Saver Bronze - PPO
- Blue Value Gold - PPO
- Blue Value Silver - PPO
- Blue Access Gold for Business - PPO
- Blue Choice Platinum for Business - PPO
- Blue HSA Silver for Business - PPO
- Blue Saver Bronze for Business - PPO
- Blue Saver Gold for Business - PPO
- Blue Secure Gold for Business - PPO
- Blue Secure Silver for Business - PPO
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- BlueCare Dental? 1D - PPO
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- BlueCare Dental? 1D - PPO
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- BlueCare Dental? 1D - PPO
- BlueCare Dental 1D - PPO
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- Delta Dental Individual and Family DPO Basic Plan for Families - PPO
- Delta Dental Individual and Family DPO Preferred Plan for Families - PPO
- Delta Dental Individual and Family DPO Preventive Plan for Families - PPO
- DeltaCare USA Basic Plan for Families - HMO
- DeltaCare USA Preferred Plan for Families - HMO
- BlueDental Copayment Q - PPO
- BlueDental Copayment QF - PPO
- Humana Dental Smart Choice - PPO
- Humana Dental Smart Choice - High - PPO
- Humana Dental Smart Choice - Lite - PPO
- Humana Dental Smart Choice - Low - PPO
- Humana Dental Smart Choice Basic - PPO
- Humana Dental Smart Choice- Lite - PPO
- Paramount Dental Essential Plus Plan - EPO
- Paramount Dental Preventive Family Plan - EPO
- Paramount Dental Total Care Plan - EPO
- HRI Essential Plus Plan - HMO
- HRI Essential Plus Plan - PPO
- HRI Preventive Family Plan - HMO
- HRI Preventive Family Plan - PPO
- HRI Total Care Plan - HMO
- HRI Total Care Plan - PPO
- Alabama Preferred Plan - PPO
- Alabama Preferred Plan (Pediatric Only) - PPO
- Alabama Preferred Plus Plan - PPO
- Alabama Preferred Plus Plan (Pediatric Only) - PPO
- Alabama Wellness Essentials Plan - PPO
- Florida Preferred Plan - PPO
- Florida Preferred Plan (Pediatric Only) - PPO
- Florida Preferred Plus Plan - PPO
- Florida Preferred Plus Plan (Pediatric Only) - PPO
- Florida Wellness Essentials Plan - PPO
- High PPO Dental Plan - PPO
- High PPO Dental Plan (Pediatric Only) - PPO
- Kansas Preferred Plan - PPO
- Kansas Preferred Plan (Pediatric Only) - PPO
- Kansas Wellness Essentials Plan - PPO
- Low PPO Dental Plan - PPO
- Low PPO Dental Plan (Pediatric Only) - PPO
- Mississippi Preferred Plan - PPO
- Mississippi Preferred Plan (Pediatric Only) - PPO
- Mississippi Wellness Essentials Plan - PPO
- TruAssure Basic Adult or Child Dental Plan - PPO
- TruAssure Preferred Adult or Child Dental Plan - PPO
- TruAssure Preventive Dental Plan - PPO
- Smile Now Arizona - No Waiting Period PPO - PPO
- Smile Now Illinois - No Waiting Period PPO - PPO
- Smile Now Michigan - No Waiting Period PPO - PPO
- Smile Now Ohio - No Waiting Period PPO - PPO
- Smile Now Tennessee - No Waiting Period PPO - PPO
- Smile Now Texas- No Waiting Period Plan - PPO
- Smile Now Utah - No Waiting Period PPO - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Andrew Hanna is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Andrew Hanna is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 7719266824
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20161114000611
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Melanoma (skin cancer) excision
New patient office or other outpatient visit, 30-44 minutes
X-ray of lower jaws, upper jaws and teeth
Melanoma excision is a procedure where a surgeon removes melanoma, a type of skin cancer, and some surrounding healthy tissue. Local anesthesia is applied to numb the area. The goal is to completely remove the cancer and prevent its spread. Healing time varies.
This service was performed for 1-10 patientsThis service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
This service was performed 18 times for 18 patientsAn X-ray of lower jaws, upper jaws, and teeth is a diagnostic procedure that uses radiation to create images of these areas. This helps in identifying issues like tooth decay, gum problems, or jawbone irregularities. It's a quick, painless process and crucial for maintaining oral health.
This service was performed 20 times for 18 patientsReviews for DR. ANDREW EMAD HANNA D.D.S., M.D.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
1 | 9 | 9 | 2 | 0 | 2 | 4 | 8 | 7 | 1 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 9 | 18 | 2 | 0 | 2 | 8 | 8 | 14 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 9 + 1 + 8 + 2 + 0 + 2 + 8 + 8 + 1 + 4 + 24 = 69 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
70 - 69 = 1 | 1 |
The NPI number 1992024871 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 2 providers are registered at the same or nearby location.
DR. ADAM JOSEPH VERRETT
Dentist
(Oral and Maxillofacial Surgery)
4499 MEDICAL DR STE 190
SAN ANTONIO, TX
ZIP 78229
MATTHEW ROBERT TORRES MD, DDS
Dentist
(Oral and Maxillofacial Surgery)
4499 MEDICAL DR STE 190
SAN ANTONIO, TX
ZIP 78229
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1992024871, enumerated as an "individual" on May 18, 2010.
The provider is located at 4499 MEDICAL DR STE 190 SAN ANTONIO, TX 78229 and the phone number is (210) 614-3915.
Oral & Maxillofacial Surgery with taxonomy code 204E00000X.
The provider might be accepting Accepts: Aetna CVS Health, Ambetter from Arizona Complete. Please consult your insurance carrier or call the provider to verify.