2018 provider directory - ht.uhccommunityplan.com · rotech healthcare - may be known locally by a...

2018PROVIDERDIRECTORY

List of network doctors and specialists

UnitedHealthcare Dual Complete (HMO SNP)

Arizona

Apache, Cochise, Coconino, Graham, Greenlee, La Paz, Mohave, Navajo, Pima, Pinal, Santa Cruz,

Yavapai and Yuma Counties

For more information, please contact Customer Service at:

Toll-Free 1-877-614-0623, TTY 7118 a.m. - 8 p.m. local time, 7 days a week

www.UHCCommunityPlan.com

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Introduction

Your plan

PROVIDER DIRECTORYThis directory provides a list of your plans network providers.This directory is for the plan listed on the cover. It is not a complete list of network providers

available to you. You can search for a network provider and print a directory online, which is

updated weekly and available 24 hours a day, 7 days a week.

This directory is current as of June 10, 2018. Some network providers may have been added or

removed from our network after this directory was printed. We do not guarantee that each provider

is still accepting new members.

For the most up-to-date information about the plans network

providers in your area:

Visit www.UHCCommunityPlan.com or call Customer Service toll-free at 1-877-614-0623,

TTY 711, 8 a.m. - 8 p.m. local time, 7 days a week.

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies,

a Medicare Advantage organization with a Medicare contract. Enrollment in the plan depends on

the plans contract renewal with Medicare.

Providers are prohibited from discriminating against any member, with regard to quality of service

or accessibility of services, on the basis of race, ethnicity, national origin, religion, sex, age, mental

or physical disability or medical condition, sexual orientation, claims experience, medical history,

evidence of insurability, disability, genetic information, or source of payment.

This information is available for free in other languages. Please call Customer Service toll-free at the

number listed above.

Esta informacin est disponible sin costo en otros idiomas. Llame a nuestro Servicio al Cliente al

nmero gratuito indicado arriba.

This document may be available in an alternate format such as Braille, larger print or audio. Please

call Customer Service at the toll-free phone number listed above.

The provider network may change at any time. You will receive notice when necessary.

Y0066_170626_143320_NM

Introduction

IntroductionThis directory provides a list of the plans network providers. To get detailed information about your

health care coverage, please see your Evidence of Coverage.

What is a primary care provider?A primary care provider (PCP) is the health care professional who provides most of your care.

Your PCP can help you:

Make smart lifestyle choices to help improve and maintain your health

Get preventive care and health screenings

Better understand your medical conditions

Coordinate any specialist care to help avoid duplicate and expensive tests.

Manage your prescriptions and identify possible harmful interactions

Select a primary care provider (PCP)You will need to choose one of our network providers to be your primary care provider (PCP). PCPs

are listed in the Primary Care Provider section of this directory. The term PCP will be used

throughout this directory.

If you choose a PCP who is not taking new patients, we may assign you to a different PCP. If this

happens, you can switch to another PCP who is accepting new patients.

Your PCP plays an important role in your health care and we want you to be comfortable with the

provider you choose. If you want to switch providers, call Customer Service toll-free at

1-877-614-0623, 8 a.m. - 8 p.m. local time, 7 days a week. TTY users should call 711.

The network providers listed in this directory have agreed to provide you with your health care

coverage. You can see a network specialist without getting a referral. If you have been going to one

network provider, you are not required to continue going to that same provider. Check your

Evidence of Coverage to make sure your plan includes additional benefits or that you've signed up

for optional supplemental riders before making appointments for dental, vision or hearing services.

If I need emergency or urgent careA medical emergency is when you, or any other ordinary person with an average knowledge of

health and medicine, believe that you have symptoms that require immediate medical care to

prevent death, loss of a limb, or loss of function of a limb. The medical symptoms may be an illness,

injury, severe pain, or a medical condition that is quickly getting worse.

If you have a medical emergency, get help as quickly as possible. Call 911 or go to the nearest

emergency room or hospital. Emergency care can always be obtained in or out of the service area

from the nearest available provider. Emergency services are also covered whether a provider is in

our network or not. You or someone else should call and tell us about your emergency care, usually

within 48 hours.

Urgently needed services is a non-emergency, unforeseen medical illness, injury, or condition, that

requires immediate medical care. When out of the service area, urgent care may be obtained from

Introductionthe first available provider whether the provider is in our network or not. In addition, when out of the

service area, you can obtain dialysis treatment from any qualified dialysis provider. If you obtain

routine care from out-of-network providers neither Medicare nor your Plan will be responsible for

the costs.

If you get a billThere may be times when you get a bill from a provider for the full cost of medical care you have

received. If you get a bill, contact us. In many cases, you should send this bill to us instead of

paying it. We will look at the bill and decide whether the services should be covered. If we decide

they should be covered, we will pay the provider directly. Please see your Evidence of Coverage for

more information.

If youre on Medicare and MedicaidIf youre a Qualified Medicare Beneficiary (QMB), your doctor may not bill you for deductibles,

copays or coinsurance for Medicare-covered services, except for Part D prescription drug copays.

Please show your member ID card and your state-issued Medicaid member ID card when you see

the doctor or use other plan services. This will help ensure youre billed for the correct amount.

Accessing your mental health benefitsTo access your mental health benefits, call the toll-free mental health number on your member ID

card. When you call, a representative will check your eligibility and get basic information about you

and your situation. Depending on the help you need, a clinician may talk with you and recommend

a provider and treatment plan. If you prefer, your PCP may call and arrange a referral for you. Your

personal information will be kept strictly confidential.

Organ transplant servicesYour plan has a nationwide network of facilities that perform organ transplants (including the heart,

lung, liver, intestine, kidney, bone marrow and/or pancreas). Solid organ transplants must be

performed at a facility that is currently Medicare-approved for your specific type of transplant. The

plans hospital network for organ transplant services is different than the network shown in the

Hospitals section of this provider directory. Some hospitals in the plans network for other

medical services are not in the plans network for transplant services. The complete list of

Medicare-approved facilities in your plans network may change throughout the year. For

information on network facilities for transplant services, please call Customer Service toll-free at

1-877-614-0623, TTY 711 or refer to the transplant vendor website information listed in the

National Vendors section of this provider directory.

What is the service area for your plan?Your service area is listed below.

UnitedHealthcare Dual Complete (HMO SNP)

Arizona - Apache, Cochise, Coconino, Graham, Greenlee, La Paz, Maricopa, Mohave, Navajo,

Pima, Pinal, Santa Cruz, Yavapai, and Yuma counties

How do you find network providers in your area?Network providers in your area are listed in the following sections of this directory. To find a

provider using this directory, turn to the Table of Contents on the next page and see where each

Introduction

section begins. Go to the section of the type of provider you are looking for. Once you are in that

section, locate the city you live in. Under each city you will find a list of providers in alphabetical

order.

You may have more providers to choose from if the service area shown above is larger than the

service area shown on the front of this directory. You can also search online at

www.UHCCommunityPlan.com, which is updated weekly and available 24 hours a day, 7 days a

week.

If you have questions about your plan or require assistance in selecting a PCP, please call our

Customer Service Department toll-free at 1-877-614-0623, TTY 711. Or visit

www.UHCCommunityPlan.com.

National Vendors............................................................................................................................................................................. 3

Primary Care Providers............................................................................................................................................................ 15

Specialists......................................................................................................................................................................................215

Skilled Nursing Facilities...................................................................................................................................................... 949

Hospitals.........................................................................................................................................................................................953

Urgent Care/Surgicenters................................................................................................................................................... 957

Ancillary...........................................................................................................................................................................................963

Acupuncture / Chiropractic.............................................................................................................................................1033

Dental............................................................................................................................................................................................ 1039

Vision............................................................................................................................................................................................. 1093

Index...............................................................................................................................................................................................1099

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Table of Contents

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National Vendors The following national vendors are available to provide services toUnitedHealthcare customers throughout the United States regardless of where you receive theservices.

Provider(s) Phone Number WebSite

Cardiac Diagnostic - Cardiac Monitoring Services

LifeWatch 1-877-774-9846 www.lifewatch.com

Preventice Services 1-888-747-1442 www.preventicesolutions.com/services/preventice-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

RediClinic 1-866-607-7334 www.rediclinic.com/riteaid

The Little Clinic 1-877-852-2677 http://www.thelittleclinic.com

Walgreens Healthcare Clinic 1-866-825-3227 www.walgreens.com/topic/pharmacy/healthcare-clinic

Dialysis

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

Home Dialysis Services LLC 1-815-741-6830 www.dccdialysis.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

Edgepark Medical Supplies 1-888-394-5375 www.edgepark.com

Medline Industries 1-800-633-5463 www.medline.com

Walmart Stores Inc. (d/b/aWalmart and Sams Club)

1-800-273-3455 www.walmart.com

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DME - Commodity, oxygen, respiratory

Lincare - may be knownlocally by a different name;refer to website

See website www.lincare.com

Rotech Healthcare - may beknown locally by a differentname; refer to website

See website www.rotech.com

DME - Commodity, oxygen, respiratory, negative pressure wound care, manual wheelchairs

Apria Healthcare 1-800-277-4288 www.apria.com

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_coaguchek.html

DME - Home PT/INR

Alere Home Monitoring 1-877-262-4669 www.ptinr.com/

DME - Incontinence, diapers, soft goods and wound care supplies

Medline Industries 1-800-633-5463 www.medline.com

DME - Mail order disposable medical supplies including Medicare-covered diabetic supplies (bloodglucose monitors, test strips and lancets)

Byram Healthcare 1-877-902-9726 www.byramhealthcare.com

Edgepark Medical Supplies 1-888-394-5375 www.edgepark.com

McKesson Patient CareSolutions

1-855-404-6727 www.mckesson.com/providers/home-care/mckesson-patient-care-solutions

DME - Mobility products - custom/complex power wheelchairs and seating systems

Hoveround Corporation 1-888-225-1547 www.hoveround.com/MobilityNow

Numotion 1-888-232-1333 www.numotion.com

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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 - 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

Prentke Romich 1-800-268-5224 www.prentrom.com

Tobii Dynavox Systems 1-866-396-2869 www.dynavoxtech.com/tobii-dynavox

DME - TENS units

Electrostim MedicalServices, 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 andfitting

hi HealthInnovations 1-866-926-6632 www.hihealthinnovations.com

Hearing Aid Services - Hearing testing, evaluation, hearing aid selection and fitting

EPIC Hearing Health Care 1-866-956-5400 www.epichearing.com

Home Health

Bayada Nurses 1-800-305-3000 / 1-888-422-9232

www.bayada.com

Heartland HealthcareServices

1-800-736-4427 / 1-419-252-5500

www.hcr-manorcare.com orwww.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

PSA Healthcare 1-770-441-1580 www.psahealthcare.com

Home Infusion

Basic Home Infusion 1-888-822-7428 www.basichomeinfusion.com

Lincare Infusion Services See website www.lincare.com

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Home Infusion - TPN, Enteral and Synagis

BioScrip Infusion Services 1-866-788-7710 www.bioscrip.com

Home Sleep Testing

NovaSom 1-877-753-3776 www.novasom.com

Virtuox 1-877-337-7111 www.virtuox.net

Watermark Medical 1-877-710-6999 http://www.watermarkmedical.com/

Hospice - Home and inpatient

AseraCare Hospice See website www.aseracare.com

Heartland HealthcareServices

1-800-736-4427 / 1-419-252-5500

www.hcr-manorcare.com orwww.heartlandhomehealth.com

Laboratory

True Health Diagnostics 1-800-268-5224 www.truehealthdiag.com

Laboratory - Anatomic pathology - including dermatopathology

Bako Integrated PhysicianSolutions

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; MELARISfor melanoma & pancreatic cancer; Theraguide 5-FU

Myriad Genetic Laboratories 1-800-469-7423 www.myriad.com

Laboratory - Clinical, pathology and genetic testing

ARUP Labs 1-800-522-2787 www.aruplab.com

BioReference Laboratories 1-800-229-5227 www.bioreference.com

Laboratory Corporation ofAmerica

1-888-522-2677 (1-888-LABCORP)

www.labcorp.com

Lineagen, Inc 1-801-931-6200 www.lineagen.com

Laboratory - Dialysis testing

Nationwide LaboratoryServices

1-888-377-3522 www.nationwidelab.com

Laboratory - Drug testing, medication monitoring

Dominion Diagnostics 1-800-511-8427 / 1-800-711-6974

www.dominiondiagnostics.com

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Laboratory - Fecal DNA screening

Exact Sciences Laboratories 1-844-870-8870 www.cologuardtest.com

Laboratory - Genetic testing

Foundation Medicine, Inc. 1-888-988-3639 www.foundationmedicine.com

GeneDx 1-301-519-2100 www.genedx.com

Natera, Inc 1-650-249-9090 www.natera.com

Sequenom Laboratories 1-877-821-7266 www.sequenom.com

Laboratory - Genetic testing (OncotypeDx)

Genomic Health 1-888-662-6897 (1-888-ONCOTYPE)

www.genomichealth.com

Laboratory - Molecular Diagnostics

ColorGenomics 1-650-651-7130 www.color.com

Veracyte 1-888-9AFIRMA www.veracyte.com

Laboratory - Molecular Oncology

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 - Predictive genetic testing for breast cancer patients (MammaPrint)

Agendia 1-888-321-2732 www.agendia.com

Laboratory - Predictive genetic testing for cardiac abnormalities

CardioDx 1-866-941-4996 www.cardiodx.com

Laboratory - Prenatal testing

Ariosa Diagnostics 1-855-927-4672 www.ariosadx.com

PerkinElmer Laboratories 1-888-762-4000 www.perkinelmer.com

Laboratory - Specialty genetic testing

CBLPath 1-877-225-7284 www.cblpath.com

Integrated Genetics 1-800-357-5744 www.integratedgenetics.com

Invitae Corporation 1-800-436-3037 www.invitae.com

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Laboratory - Specialty infectious disease diagnostic testing, molecular biology, immunology andserology

Medical DiagnosticLaboratories

1-877-269-0090 www.mdlab.com

Laboratory - Specialty laboratory

Ambry Genetics 1-866-262-7943 www.ambrygen.com

Counsyl 1-888-COUNSYL (1-888-268-6795)

www.counsyl.com

Laboratory - Specialty oncology genetic testing

Integrated Oncology 1-800-447-5816 www.integratedoncology.com

Laboratory - Therapeutic medication monitoring, drug testing

Aegis Sciences Corporation 1-800-533-7052 www.aegislabs.com

Alere Toxicology 1-800-340-4029 www.aleretoxicology.com

Essential Testing 1-855-623-0623 www.etlab.org

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

Tribal Diagnostics 1-405-896-2978 www.tribaldiagnostics.com

Other Specialty Services - Optical services - medical benefits only

Shopko Eyecare 1-800-791-7333 www.shopko-optical.com

Other Specialty Services - Urgent care services

Concentra Health Services See website www.concentra.com

Other Specialty Services - Womens health - high risk OB / prenatal care

Optum Women's andChildren's Health

1-800-950-3963 www.alere.com

Specialty Pharmacy

AllianceRx Walgreens Prime 1-888-282-5166 www.walgreenshealth.com

BriovaRx SpecialtyPharmacy

1-866-218-7398 www.briovarx.com

Specialty Pharmacy - Carticel, Elelyso and Prolastin

Dohmen Life ScienceServices

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

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Specialty Pharmacy - Xiaflex

US Bioservices 1-888-518-7246 www.usbioservices.com

Specialty Pharmacy and Home Infusion - Limited Distribution Drugs

Accredo 1-800-803-2523 www.accredo.com

BriovaRx Infusion Services 1-877-306-4036 www.axelacare.com

Option Care 1-866-827-8203 www.optioncare.com

Transportation - Fixed-Wing Air Ambulance

AirCARE1 International 1-877-760-7760 www.airambulanceone.com

AMR Air Ambulance 1-800-424-7060 www.amr-airambulance.com

Castle International See website www.castlemedflight.com

Medway Air Ambulance 1-800-233-0655 www.medwayairambulance.com

Urgent Care - Urgent care services

MedExpress Urgent Care See website www.medexpress.com

Vaccine Program - Influenza (Trivalent, Quadrivalent, High Dose, Intradermal), Pneumonia,Zostavax, Tdap, Meningococcal, Hepatitis B, HPV , MMR, MMRV, Varicella, Hepatitis A/B combo.TDAP (Tetanus, Diphtheria & Pertussis), Shingles (Zostavax), Meningitis, HPV, and Hepatitis B (age15 and up). Worksite Clinics and Retail locations

Albertsons (d/b/aAlbertsons Sav-on,Albertsons Osco)

1-877-276-9637 www.albertsons.com/pharmacy/immunizations/

CVS Pharmacy (d/b/a CVSPharmacy, Longs Drug,CarePlus Pharmacy)

1-888-358-7468 www.cvs.com/promo/promoLandingTemplate.jsp?promoLandingId=get-vaccinated

Harris Teeter See website www.harristeeter.com/in_our_stores/departments/pharmacy/flu_shots/details.aspx

H-E-B 1-210-938-8357 www.heb.com/pharmacy/services/immunizations.jsp

Kmart Pharmacy 1-800-349-0764 www.pharmacy.kmart.com

Meijer Pharmacy 1-877-363-4537 www.meijer.com/pharmacy

New Albertsons d/b/a AcmeSav-on, Jewel-Osco, StarMarkets, Shaws Osco,Safeway

1-877-276-9637 www.acmemarkets.com/pharmacy/immunizations/

Publix Pharamcy 1-800-242-1227 www.publix.com/pharmacy-wellness/pharmacy/preventive-care/vaccinations

9


Rite Aid Pharmacy 1-800-RITEAID / 1-800-748-3243

www.riteaid.com

Safeway, Inc. (d/b/aSafeway, Carrs, Pak'N Save,Pavilions, Randalls, TomThumb, Vons)

1-877-723-3929 www.safeway.com/shopstores/pharmacy

ShopKo Pharmacy 1-800-791-7333 http://pharmacy.shopko.com/flushots

The Kroger Co. (d/b/a FredMeyer, Smiths Food & DrugCenter, Ralphs Grocery,Dillons, Tom Thumb, KwikShop, Frys, King Soopers,Jay C, QFC, Bakers, CityMarket, Owens, Payless,Gerbes, Roundy's, Copps,Mariano's, Metro Market,Pick 'N Save)

See website www.kroger.com/topic/pharmacy/#/vaccinations-made-easy

United Supermarkets (d/b/aUnited Supermarket,Albertsons Market, Amigos,Market Street)

1-877-276-9637 www.unitedsupermarkets.com

Walmart Stores Inc. (d/b/aWalmart and Sams Club)

See website www.walmart.com

Vaccine Program - Influenza (Trivalent, Quadrivalent, High Dose, Intradermal), Pneumonia,Zostavax, Tdap, Meningococcal, Hepatitis B, TDAP (Tetanus, Diphtheria & Pertussis), Shingles(Zostavax), Meningitis, and Hepatitis B (age 18 and up). Worksite Clinics and Retail locations

Walgreens Immunization(d/b/a Walgreens, DuaneReade)

1-800-925-4733 https://www.walgreens.com/pharmacy/immunization

DME - DURABLE MEDICAL EQUIPMENT is certain medical equipment that is ordered by yourdoctor for use at home. DME includes but is not limited to: wheelchairs, crutches, hospital bed, IVinfusion pump, oxygen equipment, nebulizer, and walker.HOME HEALTH/HOME INFUSION CARE can either be a licensed facility or medical personnel thatcan provide health care services in the home. Services include but are not limited to nursing visits forinfusion services or wound care.LABORATORY means diagnostic testing including routine blood and urine analysis, anatomicpathology, surgical pathology, and specialty or esoteric services.SPECIALTY PHARMACY PROVIDER provides specific drug products directly to customers orphysicians.WOMEN'S HEALTH is limited to home uterine monitoring services.

10

NOTE: We only cover blood glucose monitors and test strips from the following brands: OneTouchUltra2 , OneTouch UltraMini, OneTouch Verio, OneTouch Verio IQ, OneTouch Verio Flex,ACCU-CHEK Nano SmartView, ACCU-CHEK Aviva Plus, ACCU-CHEK Guide, and ACCUCHEKAviva Connect. Other brands are not covered by our plan.

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Arizona

Apache

Family Practice

*Accomando, Elaine M, PA8, FProvider #001741697002NPI #: 1033189444625 13th St WSaint Johns, AZ 85936(928) 337-3705Provider Language(s): Navajo,SpanishHours: M 8:00AM-5:00PMTU-F 8:00AM-6:00PMHospital Affiliations: FlagstaffMedical Center*Accomando, Elaine M, PA8, FProvider #001741697014NPI #: 1033189444488 S Mountain AveSpringerville, AZ 85938(928) 333-0127Provider Language(s): Navajo,SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center*Bansal, Shipra, MD3,8, FProvider #002952075008NPI #: 1578755781625 13th St WSaint Johns, AZ 85936(928) 337-3705Provider Language(s): SpanishHours: M-F 7:00AM-6:00PMHospital Affiliations: FlagstaffMedical Center

*Bansal, Shipra, MD3,8, FProvider #002952075012NPI #: 1578755781488 S Mountain AveSpringerville, AZ 85938(928) 333-0127Provider Language(s): SpanishHours: M-F 7:30AM-6:30PMHospital Affiliations: FlagstaffMedical Center*Knecht, Richard D, MD3,8, MProvider #001096613004NPI #: 1598814261625 13th St WSaint Johns, AZ 85936(928) 337-3705Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: MoabRegional Hospital, MontroseMemorial Hospital*Knecht, Richard D, MD3,8, MProvider #001096613014NPI #: 1598814261488 S Mountain AveSpringerville, AZ 85938(928) 333-0127Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: MoabRegional Hospital, MontroseMemorial Hospital*Knecht, Richard D, MD3,8, MProvider #001096613017NPI #: 1598814261470 W Cleveland StSaint Johns, AZ 85936(928) 337-4301Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: MoabRegional Hospital, MontroseMemorial Hospital

*Mugo, Patti W, MD3,8, FProvider #005694414004NPI #: 1013272988625 13th St WSaint Johns, AZ 85936(928) 337-3705Hours: M-F 8:00AM-5:00PM*Mugo, Patti W, MD3,8, FProvider #005694414015NPI #: 1013272988488 S Mountain AveSpringerville, AZ 85938(928) 333-0127Hours: M-F 8:00AM-5:00PM*Mugo, Patti W, MD3,8, FProvider #005694414017NPI #: 1013272988470 W Cleveland StSaint Johns, AZ 85936(928) 337-4301Hours: M-F 8:00AM-5:00PM*Parker, Ronald D, MD3,8, MProvider #002755614011NPI #: 1285798405323 S Mountain Ave Ste 102Springerville, AZ 85938(928) 333-2415Provider Language(s): JapaneseHours: M-F 8:00AM-5:00PMHospital Affiliations: HavasuRegional Medical Center, La PazRegional Hospital

15

Arizona - Apache

*Accepts Medicaid. 1 Closed to new enrollment. 2 Accepting existing patients only. 3 Board Certified. 4Practice Limitations. 8 Handicap Accessible. 9 Cultural Competency Training.

Please call the providers office to confirm the providers enrollment availability and participation in theMedicaid program.

Primary Care Providers

Prim

ary Care Providers

*Sielski, James A, DO3,8, MProvider #002307367003NPI #: 1124001375118 S Mountain AveSpringerville, AZ 85938(928) 333-0562Provider Language(s): Navajo,SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center, White MountainRegional Med Center*Sielski, James A, DO3,8, MProvider #002307367011NPI #: 1124001375625 13th St WSaint Johns, AZ 85936(928) 337-3705Provider Language(s): Navajo,SpanishHours: M-F 8:00AM-6:00PMHospital Affiliations: FlagstaffMedical Center, White MountainRegional Med Center*Wilson, Sean P, MD3,8, MProvider #002447063001NPI #: 1184615650830 E Main St Unit 110Springerville, AZ 85938(928) 333-4041Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: WhiteMountain Regional Med Center

*Wilson, Sean P, MD3,8, MProvider #002447063008NPI #: 11846156501200 W Cleveland St Ste 6Saint Johns, AZ 85936(928) 337-3125Provider Language(s): SpanishHours: M 8:00AM-5:00PMTU 8:00AM-1:00PMW-F 8:00AM-5:00PMHospital Affiliations: WhiteMountain Regional Med Center*Yoder, Paul T, MD3,8, MProvider #001769024050NPI #: 1780779991470 W Cleveland StSaint Johns, AZ 85936(928) 337-4301Hours: M-F 8:00AM-5:00PMHospital Affiliations: MemorialHospital Of South Bend, YavapaiRegional Medical Center West*Yoder, Paul T, MD3,8, MProvider #001769024056NPI #: 1780779991625 13th St WSaint Johns, AZ 85936(928) 337-3705Hours: M-F 8:00AM-5:00PMHospital Affiliations: MemorialHospital Of South Bend, YavapaiRegional Medical Center West*Yoder, Paul T, MD3,8, MProvider #001769024062NPI #: 1780779991488 S Mountain AveSpringerville, AZ 85938(928) 333-0127Hours: M-F 8:00AM-5:00PMHospital Affiliations: MemorialHospital Of South Bend, YavapaiRegional Medical Center West

Federal Qualified Health CareAgency

*North Country Hc-13th1,8Provider #005354427001NPI #: 1689799827625 13th St WSaint Johns, AZ 85936(928) 337-3705Hours: M-F 8:00AM-5:00PM*North Country Hc-clevelan1,8Provider #005354498001NPI #: 1407195589470 W Cleveland StSaint Johns, AZ 85936(928) 337-4301Hours: M-F 8:00AM-5:00PM*North Country Health-round1,8Provider #005354495001NPI #: 1790809879488 S Mountain AveSpringerville, AZ 85938(928) 333-0127Hours: M-F 8:00AM-5:00PM

Internal Medicine

*Abbott, Brandon H, DO3,8, MProvider #005455599013NPI #: 1528350139488 S Mountain AveSpringerville, AZ 85938(928) 333-0127Hours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center

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Arizona - Apache

*Accepts Medicaid. 1 Closed to new enrollment. 2 Accepting existing patients only. 3 Board Certified. 4Practice Limitations. 8 Handicap Accessible. 9 Cultural Competency Training.Please call the providers office to confirm the providers enrollment availability and participation in theMedicaid program.


*Abbott, Brandon H, DO3,8, MProvider #005455599017NPI #: 1528350139625 13th St WSaint Johns, AZ 85936(928) 337-3705Hours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center*Hamblin, Scott R, MD1,3,8, MProvider #001877168002NPI #: 1972594620118 S Mountain AveSpringerville, AZ 85938(928) 333-4368Provider Language(s): JapaneseHours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center, SummitRegional Medical Center, WhiteMountain Regional Med Center*Hamblin, Scott R, MD3,8, MProvider #001877168003NPI #: 1972594620625 13th St WSaint Johns, AZ 85936(928) 337-3705Provider Language(s): JapaneseHours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center, SummitRegional Medical Center, WhiteMountain Regional Med Center

*Hamblin, Scott R, MD3,8, MProvider #001877168004NPI #: 1972594620606 N Main StEagar, AZ 85925(928) 333-5333Provider Language(s): JapaneseHours: M-TH 7:00AM-5:00PMF 8:00AM-12:00PMHospital Affiliations: FlagstaffMedical Center, SummitRegional Medical Center, WhiteMountain Regional Med Center*Jackson, Christine, MD3,8, FProvider #000015396003NPI #: 1861476889118 S Mountain AveSpringerville, AZ 85938(928) 333-0562Provider Language(s): French,SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: SummitRegional Medical Center, WhiteMountain Regional Med Center*Martin, Cynthia E, MD1,3,8, FProvider #002400013017NPI #: 1346290962488 S Mountain AveSpringerville, AZ 85938(928) 333-0127Hours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center*Martin, Cynthia E, MD1,3,8, FProvider #002400013020NPI #: 1346290962625 13th St WSaint Johns, AZ 85936(928) 337-3705Hours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center

*Newland, Anne M, MD1,3,8, FProvider #002411822009NPI #: 1336178912625 13th St WSaint Johns, AZ 85936(928) 337-3705Hours: M-F 7:00AM-6:00PM*Raja, Rubina A, MD3,8, FProvider #003161436048NPI #: 1811124530625 13th St WSaint Johns, AZ 85936(928) 337-3705Provider Language(s): Hindi,UrduHours: M-F 8:00AM-5:00PMHospital Affiliations: MountainVista Medical Center*Raja, Rubina A, MD3,8, FProvider #003161436059NPI #: 1811124530488 S Mountain AveSpringerville, AZ 85938(928) 333-0127Provider Language(s): Hindi,UrduHours: M-F 8:00AM-5:00PMHospital Affiliations: MountainVista Medical Center*Raja, Rubina A, MD3,8, FProvider #003161436062NPI #: 1811124530470 W Cleveland StSaint Johns, AZ 85936(928) 337-4301Provider Language(s): Hindi,UrduHours: M-F 8:00AM-5:00PMHospital Affiliations: MountainVista Medical Center

17

Arizona - Apache




Prim

ary Care Providers

Nurse Practitioner - FamilyPractice

*Florea, Kathleen S, NP8, FProvider #002930888008NPI #: 1275527764625 13th St WSaint Johns, AZ 85936(928) 337-3705Hours: M-F 7:00AM-6:00PM*Florea, Kathleen S, NP8, FProvider #002930888012NPI #: 1275527764488 S Mountain AveSpringerville, AZ 85938(928) 333-0127Hours: M-F 7:30AM-6:30PM*Stanley, Lisa A, NP8, FProvider #005329393005NPI #: 1003213422625 13th St WSaint Johns, AZ 85936(928) 337-3705Hours: M-F 8:00AM-5:00PMHospital Affiliations: WesternArizona Regional Medical*Stanley, Lisa A, NP8, FProvider #005329393016NPI #: 1003213422488 S Mountain AveSpringerville, AZ 85938(928) 333-0127Hours: M-F 8:00AM-5:00PMHospital Affiliations: WesternArizona Regional Medical

*Stanley, Lisa A, NP8, FProvider #005329393019NPI #: 1003213422470 W Cleveland StSaint Johns, AZ 85936(928) 337-4301Hours: M-F 8:00AM-5:00PMHospital Affiliations: WesternArizona Regional Medical

Cochise

Family Practice

*Avina, Peggy M, MD8, FProvider #001765792001NPI #: 1558362145101 Cole AveBisbee, AZ 85603(520) 432-2042Provider Language(s): SpanishHours: M-F 12:00AM-11:59PMHospital Affiliations: CopperQueen Community Hospital*Avina, Peggy M, MD8, FProvider #001765792004NPI #: 155836214510524 E Highway 92Hereford, AZ 85615(520) 366-0300Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: CopperQueen Community Hospital

*Bushman, Jeffery B, DO3,8, MProvider #000224145003NPI #: 1174603211900 W Scott StWillcox, AZ 85643(520) 384-4291Provider Language(s): SpanishHours: M-TH 7:30AM-5:00PMF 7:30AM-3:00PMHospital Affiliations: Mt GrahamRegional Medical Center,Northern Cochise CommunityHospital*Bushman, Jeffery B, DO3,8, MProvider #000224145004NPI #: 1174603211225 N Frontage RdPearce, AZ 85625(520) 826-1088Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: Mt GrahamRegional Medical Center,Northern Cochise CommunityHospital*Carnett, Mark C, DO3,8, MProvider #001407492003NPI #: 13564028874990 E Mediterranean Dr Ste ASierra Vista, AZ 85635(520) 439-4466Hours: M-TH 8:30AM-5:00PMF 8:30AM-3:30PMHospital Affiliations: CanyonVista Medical Center, CopperQueen Community Hospital,Sierra Vista Regional HealthCenter

18

Arizona - Cochise



*Crockett, Karen E, MD8, FProvider #002730535006NPI #: 1316009079108 Arizona StBisbee, AZ 85603(520) 364-1429Hours: M-F 8:00AM-5:00PMSA 9:00AM-1:00PM*Crockett, Karen E, MD8, FProvider #002730535009NPI #: 13160090791100 F AveDouglas, AZ 85607(520) 364-3282Hours: M-F 8:00AM-5:00PMSA 9:00AM-1:00PM*Crockett, Karen E, MD8, FProvider #002730535011NPI #: 13160090794525 Campus DrSierra Vista, AZ 85635(520) 459-3011Hours: M-F 8:00AM-5:00PM*Crockett, Karen E, MD8, FProvider #002730535014NPI #: 13160090794755 Campus DrSierra Vista, AZ 85635(520) 459-3011Hours: M-F 8:00AM-5:00PM*Crockett, Karen E, MD8, FProvider #002730535015NPI #: 1316009079815 E 15th StDouglas, AZ 85607(520) 364-5437Hours: M-TH 7:00AM-7:00PMF 7:00AM-5:00PMSA 9:00AM-1:00PM

*Crockett, Karen E, MD8, FProvider #002730535016NPI #: 131600907910566 N Highway 191Elfrida, AZ 85610(520) 642-2222Hours: M-F 8:00AM-5:00PM*Crockett, Karen E, MD8, FProvider #002730535017NPI #: 1316009079155 Calle Portal Ste 700Sierra Vista, AZ 85635(520) 459-3011Hours: M-F 8:00AM-5:00PM*Dorado, Sean Paul R, PA1,8, MProvider #002501438002NPI #: 1881645596300 S Ocotillo AveBenson, AZ 85602(520) 586-9111Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: BensonHospital*Fabry, Elizabeth M, NP8, FProvider #002358095011NPI #: 17806853704525 Campus DrSierra Vista, AZ 85635(520) 459-3011Provider Language(s): BurmeseHours: M-F 8:00AM-5:00PM*Fabry, Elizabeth M, NP8, FProvider #002358095016NPI #: 1780685370108 Arizona StBisbee, AZ 85603(520) 432-3309Provider Language(s): BurmeseHours: M-F 8:00AM-5:00PM

*Fabry, Elizabeth M, NP8, FProvider #002358095018NPI #: 17806853701100 F AveDouglas, AZ 85607(520) 364-3285Provider Language(s): BurmeseHours: M-F 8:00AM-5:00PM*Fabry, Elizabeth M, NP8, FProvider #002358095019NPI #: 1780685370815 E 15th StDouglas, AZ 85607(520) 364-5437Provider Language(s): BurmeseHours: M-F 8:00AM-5:00PM*Garcia-mariscal, Gloria E, MD8,FProvider #000171608001NPI #: 14179895911535 E 10th StDouglas, AZ 85607(520) 437-0329Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: CopperQueen Community Hospital,Southeast Arizona MedicalCenter*Gray, Bianca F, DO3,8, FProvider #005227763001NPI #: 137677925610524 E Highway 92Hereford, AZ 85615(520) 366-0300Hours: M-F 8:00AM-5:00PMHospital Affiliations: CopperQueen Community Hospital

19

Arizona - Cochise




Prim

ary Care Providers

*Griesemer, Kathy E, PA8, FProvider #001928626001NPI #: 1639165822101 Cole AveBisbee, AZ 85603(520) 432-2042Hours: SU-SA 12:00AM-11:59PMHospital Affiliations: CopperQueen Community Hospital*Johnson, Tonya, MD8, FProvider #005885690001NPI #: 1679825152108 Arizona StBisbee, AZ 85603(520) 432-3309Hours: M-F 7:00AM-6:00PMSA 9:00AM-3:00PM*Johnson, Tonya, MD8, FProvider #005885690002NPI #: 16798251524755 Campus DrSierra Vista, AZ 85635(520) 459-3011Hours: M-F 8:00AM-5:00PM*Johnson, Tonya, MD8, FProvider #005885690003NPI #: 1679825152155 Calle Portal Ste 700Sierra Vista, AZ 85635(520) 459-0203Hours: M-F 8:00AM-5:00PM*Johnson, Tonya, MD8, FProvider #005885690005NPI #: 16798251524525 Campus DrSierra Vista, AZ 85635(520) 459-3011Hours: M-F 8:00AM-5:00PM

*Mayberry, Andrew W, MD3,8, MProvider #001626821005NPI #: 1629019260890 W 4th St Ste 3Benson, AZ 85602(520) 586-3486Hours: M-F 8:00AM-5:00PMHospital Affiliations: BannerUniversity Med Center SouthCampus, Benson Hospital,Tucson Medical Center*Mayberry, Ralph E, MD1,3,8, MProvider #000264710001NPI #: 10634874861800 E Wilcox DrSierra Vista, AZ 85635(520) 459-3116Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: CanyonVista Medical Center, SierraVista Regional Health Center*Miles, Brian L, MD8, MProvider #001079940001NPI #: 131694078610524 E Highway 92Hereford, AZ 85615(520) 366-0300Hours: M-F 8:00AM-5:00PMHospital Affiliations: CommunityHospital South, Franciscan StFrancis Health Beech Grove,Indiana University HealthBloomington Hospital

*Miles, Brian, MD8, MProvider #001079940002NPI #: 1316940786100 E 5th StDouglas, AZ 85607(520) 364-7659Hours: M-F 8:00AM-5:00PMHospital Affiliations: CommunityHospital South, Franciscan StFrancis Health Beech Grove,Indiana University HealthBloomington Hospital*Miles, Brian, MD8, MProvider #001079940003NPI #: 1316940786101 Cole AveBisbee, AZ 85603(520) 432-2042Hours: M-F 8:00AM-5:00PMHospital Affiliations: CommunityHospital South, Franciscan StFrancis Health Beech Grove,Indiana University HealthBloomington Hospital*Parker, Ronald D, MD3,8, MProvider #002755614009NPI #: 12857984051415 W Melody Ln Bldg ABisbee, AZ 85603(520) 432-9482Provider Language(s): JapaneseHours: M-F 8:00AM-5:00PMHospital Affiliations: HavasuRegional Medical Center, La PazRegional Hospital

20

Arizona - Cochise



*Patel, Parag R, MD3,8, MProvider #002847503007NPI #: 1215121512126 S Coronado Dr Ste BSierra Vista, AZ 85635(520) 439-0115Provider Language(s): Gujarati,Hindi, UrduHours: M-TH 8:00AM-5:00PMF 8:00AM-12:00PMHospital Affiliations: CanyonVista Medical Center, SierraVista Regional Health Center*Patterson, Joseph W, MD3,8, MProvider #000265350003NPI #: 1477506277101 Cole AveBisbee, AZ 85603(520) 432-5082Hours: M-F 8:00AM-5:00PMHospital Affiliations: CanyonVista Medical Center, CopperQueen Community Hospital,Sierra Vista Regional HealthCenter*Patterson, Joseph W, MD3,8, MProvider #000265350004NPI #: 1477506277100 E 5th StDouglas, AZ 85607(520) 364-7659Hours: M-F 8:00AM-5:00PMHospital Affiliations: CanyonVista Medical Center, CopperQueen Community Hospital,Sierra Vista Regional HealthCenter

*Patterson, Joseph W, MD3,8, MProvider #000265350005NPI #: 147750627710524 E Highway 92Hereford, AZ 85615(520) 364-7659Hours: M-F 8:00AM-5:00PMHospital Affiliations: CanyonVista Medical Center, CopperQueen Community Hospital,Sierra Vista Regional HealthCenter*Polanco, Prido M, MD8, MProvider #000782032002NPI #: 1710973698100 E 5th StDouglas, AZ 85607(520) 364-7659Hours: M-F 8:00AM-5:00PMHospital Affiliations: CopperQueen Community Hospital*Polanco, Prido M, MD8, MProvider #000782032004NPI #: 171097369810524 E Highway 92Hereford, AZ 85615(520) 364-7659Hours: M-F 8:00AM-5:00PMHospital Affiliations: CopperQueen Community Hospital*Polanco, Prido-martinez M,MD8, MProvider #000782032001NPI #: 1710973698101 Cole AveBisbee, AZ 85603(520) 432-2042Hours: M-F 8:00AM-5:00PMHospital Affiliations: CopperQueen Community Hospital

*Romo, Jose H, MD8, MProvider #000965647001NPI #: 1043206394101 Cole AveBisbee, AZ 85603(520) 432-2042Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: CopperQueen Community Hospital*Romo, Jose H, MD8, MProvider #000965647002NPI #: 1043206394100 E 5th St Unit 1215Douglas, AZ 85607(520) 364-7659Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: CopperQueen Community Hospital*Safavi, Hadi, DO8, MProvider #005494504001NPI #: 1508124686155 Calle Portal Ste 300Sierra Vista, AZ 85635(520) 364-1429Hours: M-TH 7:00AM-7:00PMF 7:00AM-5:00PMSA 9:00AM-3:00PM*Safavi, Hadi, DO8, MProvider #005494504002NPI #: 1508124686108 Arizona StBisbee, AZ 85603(520) 432-3309Hours: M-F 8:00AM-5:00PM*Safavi, Hadi, DO8, MProvider #005494504005NPI #: 15081246861100 F AveDouglas, AZ 85607(520) 364-3285Hours: M-F 8:00AM-5:00PM

21

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Prim

ary Care Providers

*Safavi, Hadi, DO8, MProvider #005494504006NPI #: 15081246864525 Campus DrSierra Vista, AZ 85635(520) 459-3011Hours: M-F 8:00AM-5:00PM*Safavi, Hadi, DO8, MProvider #005494504008NPI #: 1508124686815 E 15th StDouglas, AZ 85607(520) 364-3285Hours: M-F 8:00AM-5:00PM*Safavi, Hadi, DO8, MProvider #005494504014NPI #: 15081246864755 Campus DrSierra Vista, AZ 85635(520) 459-3011Hours: M-F 8:00AM-5:00PM*Thomas, Laurie A, MD3,8, FProvider #001757402019NPI #: 1730399353101 Cole AveBisbee, AZ 85603(520) 432-2042Hours: M-F 8:00AM-5:00PMHospital Affiliations: BannerUniversity Med Center TucsonCampus, El Dorado Hospital, StJoseph's Hospital, TucsonMedical Center, UniversityMedical Center

*Thomas, Laurie A, MD3,8, FProvider #001757402020NPI #: 173039935310524 E Highway 92Hereford, AZ 85615(520) 364-7659Hours: M-F 8:00AM-5:00PMHospital Affiliations: BannerUniversity Med Center TucsonCampus, El Dorado Hospital, StJoseph's Hospital, TucsonMedical Center, UniversityMedical Center*Wilde, Jeffrey V, MD3,8, MProvider #003116433002NPI #: 1073703310286 S Lenzner AveSierra Vista, AZ 85635(520) 452-0379Hours: M-TH 7:00AM-4:30PMF 7:00AM-3:00PMHospital Affiliations: CanyonVista Medical Center, DeltaCommunity Hospital, FillmoreCommunity Hospital, HeberValley Hospital, Sanpete ValleyHospital, Sevier Valley Hospital,Sierra Vista Regional HealthCenter, Utah Valley Hospital*Wu, Alfred P, MD8, MProvider #000896440001NPI #: 15583860031906 E 11th StDouglas, AZ 85607(520) 364-1120Provider Language(s): Chinese,SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: CochiseRegional Hospital, CopperQueen Community Hospital,Southeast Arizona MedicalCenter


*15th Street Pediatric Center1,8Provider #005394421001NPI #: 1174820898815 E 15th StDouglas, AZ 85607(520) 364-5437Hours: SU 9:00AM-1:00PMM-TH 7:00AM-7:00PMF 7:00AM-5:00PMSA 9:00AM-3:00PM*Chiricahua Community Hc-bisbee1,8Provider #005394508001NPI #: 1063540144108 Arizona StBisbee, AZ 85603(520) 364-3285Hours: M-F 8:00AM-5:00PM*Chiricahua Community Hc-jennif1,8Provider #005394489001NPI #: 18018219701100 F AveDouglas, AZ 85607(520) 364-1429Hours: M-F 8:00AM-5:00PM*Chiricahua Community Hc-sierra 3001,8Provider #005394478001NPI #: 14173317114525 Campus DrSierra Vista, AZ 85635(520) 459-3011Hours: M-F 8:00AM-5:00PM

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*Chiricahua Community Hc-vista1,8Provider #005394466001NPI #: 18213090891590 Paseo San LuisSierra Vista, AZ 85635(520) 459-0203Hours: M-F 8:00AM-5:00PM*Chiricahua Community HealthCenters8Provider #006536900001NPI #: 14871751624755 Campus DrSierra Vista, AZ 85635(520) 459-3011Hours: M-F 8:00AM-5:00PM*Chiricahua Community HealthCenters8Provider #006536900002NPI #: 1174820898815 E 15th StDouglas, AZ 85607(520) 364-5437Hours: M-F 8:00AM-5:00PM

General Practice

*Clark, Amy C, DO8, FProvider #005116257010NPI #: 1649595174108 Arizona StBisbee, AZ 85603(520) 432-3309Hours: M-F 8:00AM-5:00PM*Clark, Amy C, DO8, FProvider #005116257012NPI #: 16495951741100 F AveDouglas, AZ 85607(520) 364-3285Hours: M-F 8:00AM-5:00PM

*Clark, Amy C, DO8, FProvider #005116257013NPI #: 1649595174815 E 15th StDouglas, AZ 85607(520) 364-5437Hours: M-F 8:00AM-5:00PM*Clark, Amy C, DO8, FProvider #005116257014NPI #: 16495951744755 Campus DrSierra Vista, AZ 85635(520) 459-3011Hours: M-F 8:00AM-5:00PM*Clark, Amy C, DO8, FProvider #005116257015NPI #: 1649595174155 Calle Portal Ste 300Sierra Vista, AZ 85635(520) 459-3011Hours: M-F 7:00AM-5:00PM*Garcia-mariscal, Gloria E, MD8,FProvider #000171608001NPI #: 14179895911535 E 10th StDouglas, AZ 85607(520) 437-0329Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: CopperQueen Community Hospital,Southeast Arizona MedicalCenter*Polanco, Prido M, MD8, MProvider #000782032002NPI #: 1710973698100 E 5th StDouglas, AZ 85607(520) 364-7659Hours: M-F 8:00AM-5:00PMHospital Affiliations: CopperQueen Community Hospital

*Polanco, Prido M, MD8, MProvider #000782032004NPI #: 171097369810524 E Highway 92Hereford, AZ 85615(520) 364-7659Hours: M-F 8:00AM-5:00PMHospital Affiliations: CopperQueen Community Hospital*Polanco, Prido-martinez M,MD8, MProvider #000782032001NPI #: 1710973698101 Cole AveBisbee, AZ 85603(520) 432-2042Hours: M-F 8:00AM-5:00PMHospital Affiliations: CopperQueen Community Hospital*Romo, Jose H, MD8, MProvider #000965647001NPI #: 1043206394101 Cole AveBisbee, AZ 85603(520) 432-2042Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: CopperQueen Community Hospital*Romo, Jose H, MD8, MProvider #000965647002NPI #: 1043206394100 E 5th St Unit 1215Douglas, AZ 85607(520) 364-7659Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: CopperQueen Community Hospital

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Prim

ary Care Providers

*Singer, Ezra R, MD8, MProvider #000949973003NPI #: 1932159399900 W Scott StWillcox, AZ 85643(520) 384-4421Hours: M-F 8:00AM-5:00PMHospital Affiliations: NorthernCochise Community Hospital

Internal Medicine

*Bansal, Archana, MD3,8, MProvider #002669311001NPI #: 1881663615157 N Coronado Dr Ste CSierra Vista, AZ 85635(520) 458-0993Hours: M-TH 8:00AM-5:00PMF 8:00AM-1:00PMSA 9:00AM-1:00PMHospital Affiliations: CanyonVista Medical Center, SierraVista Regional Health Center*Bosah, Augustine O, MD3,8, MProvider #002999561001NPI #: 15887941921939 Frontage Rd Ste GSierra Vista, AZ 85635(520) 335-6204Hours: M 8:00AM-5:00PMTU-W 8:00AM-1:00PMTH-SA 9:00AM-5:00PMHospital Affiliations: ClovisPlains Regional Med Ct*Garcia Suero, Luis E, MD8, MProvider #006169624002NPI #: 15789964681100 F AveDouglas, AZ 85607(520) 364-3285Hours: M-F 7:00AM-7:00PM

*Garcia Suero, Luis E, MD8, MProvider #006169624003NPI #: 15789964684525 Campus DrSierra Vista, AZ 85635(520) 459-3011Hours: M-F 8:00AM-5:00PM*Garcia Suero, Luis E, MD8, MProvider #006169624004NPI #: 1578996468815 E 15th StDouglas, AZ 85607(520) 364-5437Hours: M-F 8:00AM-5:00PM*Garcia Suero, Luis E, MD8, MProvider #006169624006NPI #: 15789964684755 Campus DrSierra Vista, AZ 85635(520) 459-3011Hours: M-F 8:00AM-5:00PM*Gil, Maryslenni, MD8, FProvider #006197216001NPI #: 12759656831100 F AveDouglas, AZ 85607(520) 364-3285Provider Language(s): SpanishHours: M-F 7:00AM-7:00PM*Gil, Maryslenni, MD8, FProvider #006197216002NPI #: 12759656834755 Campus DrSierra Vista, AZ 85635(520) 459-3011Provider Language(s): SpanishHours: M-F 8:00AM-5:00PM

*Gray, Michael R, MD1,8, MProvider #000382010001NPI #: 1639120520300 S Ocotillo AveBenson, AZ 85602(520) 586-9111Hours: M-F 8:00AM-5:00PMHospital Affiliations: BensonHospital, Canyon Vista MedicalCenter, Carondelet St MarysHospital, El Dorado Hospital,Sierra Vista Regional HealthCenter, St Joseph's Hospital,Tucson Medical Center*Harrison, Cassandra C, MD3,8,FProvider #001318072013NPI #: 1992874606890 W 4th StBenson, AZ 85602(520) 586-3664Hours: M-F 8:00AM-5:00PMHospital Affiliations: BannerUniversity Med Center TucsonCampus, Baptist Medical Center,Tucson Medical Center,University Medical Center*Herrod, John N, MD1,8, MProvider #001306432001NPI #: 1821022484286 S Lenzner AveSierra Vista, AZ 85635(480) 609-9350Hours: M-TH 7:00AM-4:30PMF 7:00AM-3:00PMHospital Affiliations: CanyonVista Medical Center, SierraVista Regional Health Center

24

Arizona - Cochise



*Knapp, David J, MD1,8, MProvider #001321937001NPI #: 137673561375 Colonia De Salud Ste 200aSierra Vista, AZ 85635(520) 458-8145Hours: M-W 8:00AM-5:00PMTH 8:00AM-12:00PMF 8:00AM-5:00PMHospital Affiliations: CanyonVista Medical Center, SierraVista Regional Health Center*Lesueur, Philip M, MD8, MProvider #006401135001NPI #: 11941615051800 E Wilcox DrSierra Vista, AZ 85635(520) 459-3116Hours: M-F 8:00AM-5:00PM*Lesueur, Philip M, MD8, MProvider #006401135002NPI #: 11941615054524 E Hereford RdHereford, AZ 85615(520) 459-3116Hours: M-F 8:00AM-5:00PM*Lodge, Heidi L, MD3,8, FProvider #001279000001NPI #: 1669426144101 Cole AveBisbee, AZ 85603(520) 432-5105Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: CopperQueen Community Hospital

*Lodge, Heidi L, MD3,8, FProvider #001279000002NPI #: 1669426144100 E 5th StDouglas, AZ 85607(520) 364-7659Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: CopperQueen Community Hospital*Lodge, Heidi L, MD3,8, FProvider #001279000004NPI #: 166942614410524 E Highway 92Hereford, AZ 85615(520) 364-7659Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: CopperQueen Community Hospital*McKenzie, Barry A, MD3,8, MProvider #001254401004NPI #: 19422862165151 E Highway 90Sierra Vista, AZ 85635(520) 803-6644Hours: M-F 8:00AM-5:00PMHospital Affiliations: CarrisHealth-rice MemorialHospital(hospital, CentralWashington Hospital, EasternMaine Medical Center, KingmanRegional Medical Center,McKenzie Willamette MedicalCenter, Sacred Heart UniversityDistrict, Samaritan LebanonCommunity Hospital,Wenatchee Valley Hospital

*Molina, Robert A, MD3,8, MProvider #003581835006NPI #: 15888038375750 E Highway 90 Ste 200Sierra Vista, AZ 85635(520) 263-3500Provider Language(s): SpanishHours: M-F 8:00AM-5:00PM*Patel, Santsaran C, MD8, MProvider #001314306001NPI #: 13169600161620 E Wilcox DrSierra Vista, AZ 85635(520) 458-1585Provider Language(s): Gujarati,HindiHours: M-F 7:30AM-5:00PMHospital Affiliations: CanyonVista Medical Center, SierraVista Regional Health Center*Perez Gomez, Juan, MD3,8, MProvider #006249677001NPI #: 1437582558108 Arizona StBisbee, AZ 85603(520) 432-3309Provider Language(s): SpanishHours: M-F 8:00AM-5:00PM*Perez Gomez, Juan, MD3,8, MProvider #006249677003NPI #: 1437582558155 Calle Portal Ste 700Sierra Vista, AZ 85635(520) 459-0203Provider Language(s): SpanishHours: M-F 8:00AM-5:00PM

25

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Prim

ary Care Providers

*Perez Gomez, Juan, MD3,8, MProvider #006249677005NPI #: 14375825581100 F AveDouglas, AZ 85607(520) 364-3285Provider Language(s): SpanishHours: M-F 7:00AM-7:00PM*Perez Gomez, Juan, MD3,8, MProvider #006249677006NPI #: 1437582558815 E 15th StDouglas, AZ 85607(520) 364-5437Provider Language(s): SpanishHours: M-F 8:00AM-5:00PM*Perez Gomez, Juan, MD3,8, MProvider #006249677007NPI #: 14375825584755 Campus DrSierra Vista, AZ 85635(520) 459-3011Provider Language(s): SpanishHours: M-F 8:00AM-5:00PM*Robertson, Glenn G, MD8, MProvider #002460615004NPI #: 11745335091069 S Highway 80Benson, AZ 85602(520) 586-8948Hours: M-F 9:00AM-5:00PMHospital Affiliations: BensonHospital, Northwest MedicalCenter*Rodriguezkalaf, Ivan R, MD8, MProvider #006169629007NPI #: 12052602211100 F AveDouglas, AZ 85607(520) 364-3285Hours: M-F 7:00AM-7:00PM

*Rodriguezkalaf, Ivan R, MD8, MProvider #006169629008NPI #: 12052602214755 Campus DrSierra Vista, AZ 85635(520) 459-3011Hours: M-F 8:00AM-5:00PM*Sarsah, Benjamin K, MD8, MProvider #002973084007NPI #: 1144483132450 S Ocotillo AveBenson, AZ 85602(520) 623-2642Provider Language(s): TwiHours: M-F 8:00AM-5:00PMHospital Affiliations: AbrazoArizona Heart Hospital, AbrazoScottsdale Campus, BannerBaywood Medical Center,Kindred Hospital ArizonaPhoenix*Sarsah, Benjamin K, MD8, MProvider #002973084010NPI #: 1144483132900 W Scott StWillcox, AZ 85643(520) 327-6265Provider Language(s): TwiHours: M-F 8:00AM-5:00PMHospital Affiliations: AbrazoArizona Heart Hospital, AbrazoScottsdale Campus, BannerBaywood Medical Center,Kindred Hospital ArizonaPhoenix

*Sarsah, Benjamin K, MD8, MProvider #002973084012NPI #: 114448313299 E 16th StDouglas, AZ 85607(520) 327-6265Provider Language(s): TwiHours: M-F 8:00AM-5:00PMHospital Affiliations: AbrazoArizona Heart Hospital, AbrazoScottsdale Campus, BannerBaywood Medical Center,Kindred Hospital ArizonaPhoenix*Sarsah, Benjamin K, MD8, MProvider #002973084016NPI #: 11444831325750 E Highway 90 Ste 200Sierra Vista, AZ 85635(520) 327-6265Provider Language(s): TwiHours: M-F 8:00AM-5:00PMHospital Affiliations: AbrazoArizona Heart Hospital, AbrazoScottsdale Campus, BannerBaywood Medical Center,Kindred Hospital ArizonaPhoenix*Serfino, Leonardo C, MD3,8, MProvider #002258427001NPI #: 18311147431590 Paseo San Luis Ste 101Sierra Vista, AZ 85635(520) 220-5711Hours: M-F 8:00AM-5:00PMHospital Affiliations: CanyonVista Medical Center, SierraVista Regional Health Center

26

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*Smith, Jennifer, MD3,8, FProvider #006644922008NPI #: 136660193210566 N Highway 191Elfrida, AZ 85610(520) 642-2222Hours: M-F 8:00AM-5:00PMHospital Affiliations: Dhhs PhsIhs Tucson Area Ihs Tucson Sell*Smith, Jennifer, MD3,8, FProvider #006644922011NPI #: 13666019324755 Campus DrSierra Vista, AZ 85635(520) 459-3011Hours: M-F 8:00AM-5:00PMHospital Affiliations: Dhhs PhsIhs Tucson Area Ihs Tucson Sell*Smith, Jennifer, MD3,8, FProvider #006644922012NPI #: 13666019321100 F AveDouglas, AZ 85607(520) 364-3285Hours: M-F 8:00AM-5:00PMHospital Affiliations: Dhhs PhsIhs Tucson Area Ihs Tucson Sell*Smith, Jennifer, MD3,8, FProvider #006644922013NPI #: 1366601932815 E 15th StDouglas, AZ 85607(250) 364-5437Hours: M-F 8:00AM-5:00PMHospital Affiliations: Dhhs PhsIhs Tucson Area Ihs Tucson Sell

*Smith, Jennifer, MD3,8, FProvider #006644922014NPI #: 1366601932108 Arizona StBisbee, AZ 85603(520) 432-3309Hours: M-F 8:00AM-5:00PMHospital Affiliations: Dhhs PhsIhs Tucson Area Ihs Tucson Sell*Tejero, Ana I, DO3,8, FProvider #003113022009NPI #: 1043422629101 Cole AveBisbee, AZ 85603(520) 432-6460Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: CopperQueen Community Hospital, SEGeorgia Health System-camdenCampus*Tejero, Ana, DO3,8, FProvider #003113022008NPI #: 1043422629100 5th StBisbee, AZ 85603(520) 364-7659Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: CopperQueen Community Hospital, SEGeorgia Health System-camdenCampus


*Bayham-hicks, Shirley L, NP8, FProvider #002158759004NPI #: 11442169202305 E Wilcox DrSierra Vista, AZ 85635(423) 473-5867Hours: M-F 8:00AM-5:00PM

*Bayham-hicks, Shirley L, NP8, FProvider #002158759006NPI #: 1144216920660 S Coronado DrSierra Vista, AZ 85635(520) 439-0115Hours: M-F 8:00AM-5:00PM*Bayham-hicks, Shirley L, NP8, FProvider #002158759007NPI #: 1144216920126 S Coronado Dr Ste BSierra Vista, AZ 85635(520) 439-0115Hours: M-TH 8:00AM-5:00PMF 8:00AM-12:00PM*Chavez, Nicole M, NP8, FProvider #003002482002NPI #: 1437395092100 E 5th StDouglas, AZ 85607(520) 364-7659Hours: M-F 8:00AM-5:00PMHospital Affiliations: CopperQueen Community Hospital*Hilton, Julie A, NP1,8, FProvider #002997241003NPI #: 1679721476801 W Rex Allen DrWillcox, AZ 85643(520) 766-5000Hours: M-F 8:00AM-5:00PMHospital Affiliations: NorthernCochise Community Hospital*Hron, Sherry E, NP8, FProvider #005199204001NPI #: 1285057117225 N Frontage RdPearce, AZ 85625(520) 826-1088Hours: M-F 8:00AM-5:00PMHospital Affiliations: NorthernCochise Community Hospital

27

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Prim

ary Care Providers

*Hron, Sherry E, NP8, FProvider #005199204002NPI #: 1285057117900 W Scott StWillcox, AZ 85643(520) 384-4421Hours: M-F 8:00AM-5:00PMHospital Affiliations: NorthernCochise Community Hospital

Rural Health Clinic

*Copper Queen Med-5th St1,8Provider #005376759001NPI #: 1942217088100 E 5th StDouglas, AZ 85607(520) 364-7659Hours: M-F 8:00AM-5:00PM*Copper Queen Med-cole1,8Provider #005376778001NPI #: 1508137209101 Cole AveBisbee, AZ 85603(520) 432-2042Hours: M-F 8:00AM-5:00PM*Palominas Hereford Rhc1,8Provider #005376786001NPI #: 122543810410524 E Highway 92Hereford, AZ 85615(520) 366-0300Hours: M-F 8:00AM-5:00PM*Sulphur Springs MedicalCenter1,8Provider #005372451001NPI #: 1427456706900 W Scott StWillcox, AZ 85643(520) 384-4421Hours: M-F 8:00AM-5:00PM

*Sunsites Medical Clinic1,8Provider #005372476001NPI #: 1437557642223 N Frontage RdPearce, AZ 85625(520) 826-1088Hours: M-F 8:00AM-5:00PM

Coconino

Family Practice

*Accomando, Elaine M, PA8, FProvider #001741697003NPI #: 10331894441 Clinic RdGrand Canyon, AZ 86023(928) 638-2551Provider Language(s): Navajo,SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center*Accomando, Elaine M, PA8, FProvider #001741697004NPI #: 1033189444301 S 7th StWilliams, AZ 86046(928) 635-4441Provider Language(s): Navajo,SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center

*Accomando, Elaine M, PA8, FProvider #001741697010NPI #: 10331894442920 N 4th StFlagstaff, AZ 86004(928) 213-6100Provider Language(s): Navajo,SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center*Alaishuski, Lindsay A, MD3,8, FProvider #003237118001NPI #: 10838119541 Clinic RdGrand Canyon, AZ 86023(928) 638-2551Hours: M-F 8:00AM-5:00PMHospital Affiliations: ProvidenceHospital*Bansal, Shipra, MD3,8, FProvider #002952075001NPI #: 15787557812920 N 4th StFlagstaff, AZ 86004(928) 213-6100Provider Language(s): SpanishHours: M-TH 7:00AM-7:00PMF 7:00AM-6:00PMHospital Affiliations: FlagstaffMedical Center*Bansal, Shipra, MD3,8, FProvider #002952075003NPI #: 15787557811 Clinic RdGrand Canyon, AZ 86023(928) 638-2551Provider Language(s): SpanishHours: M-F 8:00AM-6:00PMHospital Affiliations: FlagstaffMedical Center

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*Bansal, Shipra, MD3,8, FProvider #002952075004NPI #: 1578755781301 S 7th StWilliams, AZ 86046(928) 635-4441Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center*Bansal, Shipra, MD3,8, FProvider #002952075010NPI #: 15787557812187 N Vickey St Ste 2Flagstaff, AZ 86004(928) 714-5322Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center*Bjork, Janeen C, MD3,8, FProvider #002225622003NPI #: 1932103462440 N Navajo DrPage, AZ 86040(928) 645-1700Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMSA 8:00AM-6:00PMHospital Affiliations: BannerPage Hospital*Clarke, Patricia S, MD8, FProvider #002082486001NPI #: 1073556379606 N Beaver StFlagstaff, AZ 86001(928) 774-3373Hours: M-TH 9:00AM-5:00PMF 9:00AM-1:00PM

*Crane, Jesse M, DO8, MProvider #005099692001NPI #: 15485205051 Clinic RdGrand Canyon, AZ 86023(928) 638-2551Hours: M-F 8:00AM-5:00PMHospital Affiliations: Iu HealthWest Hospital*Crane, Jesse M, DO8, MProvider #005099692003NPI #: 15485205052920 N 4th StFlagstaff, AZ 86004(928) 213-6100Hours: M-TH 7:00AM-7:00PMF 7:00AM-6:00PMSA 8:00AM-5:00PMHospital Affiliations: Iu HealthWest Hospital*Davis, Bethany A, MD8, FProvider #006085643001NPI #: 19820488562920 N 4th StFlagstaff, AZ 86004(928) 213-6100Hours: M-TH 7:00AM-7:00PMF 7:00AM-6:00PMSA 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center*Dekutoski, Shaun E, MD, MProvider #000931515009NPI #: 18715487191515 E Cedar Ave Ste E-2Flagstaff, AZ 86004(928) 779-4550Hours: M-F 8:00AM-5:00PM

*Delawar, Nazir, MD3,8, MProvider #003069609001NPI #: 12555324871200 N Beaver StFlagstaff, AZ 86001(928) 214-2920Hours: M-F 8:00AM-5:00PMHospital Affiliations: Avera StMarys Hospital, Prairie LakesHealthcare System*Demangone, Michael J, MD3,8,MProvider #001833936002NPI #: 1841294378463 S Lake Powell BlvdPage, AZ 86040(508) 836-3663Hours: M-F 8:00AM-5:00PMHospital Affiliations: BannerPage Hospital, Little ColoradoMedical Center*Diehl, Kent A, MD3,8, MProvider #002456100008NPI #: 1194745133107 E Oak Ave Ste 201Flagstaff, AZ 86001(928) 913-8800Hours: M-F 8:00AM-5:00PMHospital Affiliations: Chi StAlexius Health Bismarck, OroValley Hospital, Sanford MedicalCenter

29

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Prim

ary Care Providers

*Dill, Jane E, MD3,8, FProvider #002388763001NPI #: 11544137632920 N 4th StFlagstaff, AZ 86004(928) 213-6100Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: BannerBoswell Medical Center, BannerUniversity Medical CenterPhoenix Campus, FlagstaffMedical Center*Dill, Jane E, MD3,8, FProvider #002388763005NPI #: 11544137631 Clinic RdGrand Canyon, AZ 86023(928) 638-2551Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: BannerBoswell Medical Center, BannerUniversity Medical CenterPhoenix Campus, FlagstaffMedical Center*Doroz, Michelle K, MD3, FProvider #002880995001NPI #: 1891825022710 N Beaver St Bldg 6Flagstaff, AZ 86001(928) 527-4325Hours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center, SouthwestMemorial Hospital

*Doroz, Michelle K, MD3,8, FProvider #002880995004NPI #: 18918250221501 S Yale St Ste 150Flagstaff, AZ 86001(928) 527-4325Hours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center, SouthwestMemorial Hospital*Foley, Dennis J, MD3,8, MProvider #001937529003NPI #: 1194729632440 N Navajo DrPage, AZ 86040(928) 645-1700Hours: M-SA 8:00AM-6:00PMHospital Affiliations: BannerPage Hospital, Mary BridgeChild Hospital/health Center,Tacoma General Allenmore*Gibula, Richard A, MD3,8, MProvider #000674099005NPI #: 1376637611301 S 7th StWilliams, AZ 86046(928) 635-4441Hours: M-F 8:00AM-6:00PMHospital Affiliations: FawcettMemorial Hospital, Verde ValleyMedical Center*Gilliam, John S, MD8, MProvider #001739903024NPI #: 10038770851100 N San Francisco St Ste EFlagstaff, AZ 86001(928) 774-3318Provider Language(s): SpanishHours: M-F 8:00AM-5:00PM

*Henderson, Jennifer G, DO3,8, FProvider #004956707005NPI #: 19021238882000 S Thompson StFlagstaff, AZ 86001(928) 226-6400Hours: M-F 8:00AM-5:00PM*Hershey, Lloyd G, DO8, MProvider #000322388002NPI #: 13069003601500 E Cedar Ave Ste 26Flagstaff, AZ 86004(928) 773-1234Hours: M-F 8:00AM-6:00PMHospital Affiliations: FlagstaffMedical Center*Hipkin, David, MD8, MProvider #001012651036NPI #: 1538130109463 S Lake Powell BlvdPage, AZ 86040(928) 645-0945Hours: M-F 8:00AM-5:00PMHospital Affiliations: BannerPage Hospital, North ColoradoMedical Center*Holsten, Raymond L, MD3,8, MProvider #001701339002NPI #: 1003810540467 Vista AvePage, AZ 86040(602) 645-8123Hours: M-F 8:00AM-6:00PMSA 8:00AM-12:00PMHospital Affiliations: BannerPage Hospital

30

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*Holsten, Raymond L, MD3,8, MProvider #001701339005NPI #: 1003810540440 N Navajo DrPage, AZ 86040(928) 428-1500Hours: M-SA 8:00AM-6:00PMHospital Affiliations: BannerPage Hospital*Holsten, Raymond L, MD3,8, MProvider #001701339009NPI #: 1003810540501 N Navajo DrPage, AZ 86040(928) 645-0112Hours: M-F 8:00AM-5:00PMHospital Affiliations: BannerPage Hospital*Knecht, Richard D, MD3,8, MProvider #001096613001NPI #: 15988142611 Clinic RdGrand Canyon, AZ 86023(928) 233-5110Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: MoabRegional Hospital, MontroseMemorial Hospital*Knecht, Richard D, MD3,8, MProvider #001096613005NPI #: 1598814261301 S 7th StWilliams, AZ 86046(928) 635-4441Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: MoabRegional Hospital, MontroseMemorial Hospital

*Knecht, Richard D, MD3,8, MProvider #001096613011NPI #: 15988142612920 N 4th StFlagstaff, AZ 86004(928) 522-6400Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: MoabRegional Hospital, MontroseMemorial Hospital*Knecht, Richard D, MD3,8, MProvider #001096613012NPI #: 15988142612187 N Vickey St Ste 2Flagstaff, AZ 86004(928) 527-1899Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: MoabRegional Hospital, MontroseMemorial Hospital*Knecht, Richard D, MD3,8, MProvider #001096613018NPI #: 15988142611120 W University Ave Ste 101Flagstaff, AZ 86001(928) 522-1300Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: MoabRegional Hospital, MontroseMemorial Hospital*Lieder, Emily R, MD3,8, FProvider #003609594001NPI #: 14970704292920 N 4th StFlagstaff, AZ 86004(928) 213-6100Hours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center

*Martin, John A, MD3,8, MProvider #002400017003NPI #: 18816456461501 S Yale St Ste 150Flagstaff, AZ 86001(928) 527-4325Hours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center*Martin, John A, MD3,8, MProvider #002400017004NPI #: 1881645646710 N Beaver St Bldg 6Flagstaff, AZ 86001(928) 527-4325Hours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center*Mogk, Neal W, MD3,8, MProvider #000554137003NPI #: 1508919945107 E Oak Ave Ste 101Flagstaff, AZ 86001(928) 774-7345Hours: M-F 7:00AM-6:30PMSA 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center*Monroy, Carrie J, MD3,8, FProvider #001924317001NPI #: 13462221063150 N Winding Brook RdFlagstaff, AZ 86001(928) 556-0060Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center

31

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ary Care Providers

*Mugo, Patti W, MD3,8, FProvider #005694414005NPI #: 10132729881 Clinic RdGrand Canyon, AZ 86023(928) 522-6400Hours: M-F 8:00AM-5:00PM*Mugo, Patti W, MD3,8, FProvider #005694414006NPI #: 1013272988301 S 7th StWilliams, AZ 86046(928) 635-4441Hours: M-F 8:00AM-5:00PM*Mugo, Patti W, MD3,8, FProvider #005694414012NPI #: 10132729882920 N 4th StFlagstaff, AZ 86004(928) 522-6400Hours: M-F 8:00AM-5:00PM*Mugo, Patti W, MD3,8, FProvider #005694414013NPI #: 10132729882187 N Vickey St Ste 2Flagstaff, AZ 86004(928) 527-1899Hours: M-F 8:00AM-5:00PM*Mugo, Patti W, MD3,8, FProvider #005694414018NPI #: 10132729881120 W University Ave Ste 101Flagstaff, AZ 86001(928) 522-1300Hours: M-F 8:00AM-5:00PM

*Myers, Thomas M, MD8, MProvider #001624453001NPI #: 10533851531 Clinic RdGrand Canyon, AZ 86023(928) 522-9600Provider Language(s): German,SpanishHours: SU-SA 7:00AM-6:00PMHospital Affiliations: FlagstaffMedical Center*Myers, Thomas M, MD8, MProvider #001624453002NPI #: 1053385153301 S 7th StWilliams, AZ 86046(520) 635-4441Provider Language(s): German,SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center*Myers, Thomas M, MD8, MProvider #001624453005NPI #: 10533851532920 N 4th StFlagstaff, AZ 86004(928) 213-6100Provider Language(s): German,SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center

*O'donnell, Meghan R, MD1,3, FProvider #002928833001NPI #: 1659323186710 N Beaver St Bldg 6Flagstaff, AZ 86001(928) 527-4325Hours: M-TU 8:00AM-5:00PMW 8:00AM-12:00PMTH-F 8:00AM-2:00PMHospital Affiliations: FlagstaffMedical Center*O'donnell, Meghan R, MD1,3,8, FProvider #002928833003NPI #: 16593231861501 S Yale St Bldg 2-150Flagstaff, AZ 86001(928) 527-4325Hours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center*Porvaznik, Mary C, MD3,8, FProvider #003046661001NPI #: 1871582635107 E Oak Ave Ste 201Flagstaff, AZ 86001(928) 213-8800Hours: M-F 7:00AM-6:30PMSA 8:00AM-5:00PM*Schraudenbach, Cooper C,MD3,8, MProvider #003444190001NPI #: 17908482992920 N 4th StFlagstaff, AZ 86004(928) 213-6100Provider Language(s): SpanishHours: M-F 8:00AM-5:00PM

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*Schraudenbach, Cooper C,MD3,8, MProvider #003444190002NPI #: 17908482991 Clinic RdGrand Canyon, AZ 86023(928) 638-2551Provider Language(s): SpanishHours: M-F 8:00AM-5:00PM*Seby, Mark V, MD1,3,8, MProvider #000561110002NPI #: 1649277492417 N Agassiz St Bldg 1Flagstaff, AZ 86001(928) 779-4200Provider Language(s): FrenchHours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center*Sielski, James1 A, DO3,8, MProvider #002307367008NPI #: 11240013752920 N 4th StFlagstaff, AZ 86004(928) 213-6100Provider Language(s): Navajo,SpanishHours: M-TH 7:00AM-7:00PMF 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center, White MountainRegional Med Center*Smith, Charles H, MD3,8, MProvider #001849235001NPI #: 10533839502920 N 4th StFlagstaff, AZ 86004(928) 213-6100Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center

*Stone, Frederick C, MD3,8, MProvider #001983797003NPI #: 13563074412920 N 4th StFlagstaff, AZ 86004(928) 213-6100Hours: M-F 8:00AM-5:00PMHospital Affiliations: AbrazoCentral Campus, Cooper CountyMemorial Hospital, FlagstaffMedical Center, UniversityHospitals And Clinics*Yoder, Paul T, MD3,8, MProvider #001769024051NPI #: 17807799911 Clinic RdGrand Canyon, AZ 86023(928) 638-2551Hours: M-F 8:00AM-5:00PMHospital Affiliations: MemorialHospital Of South Bend, YavapaiRegional Medical Center West*Yoder, Paul T, MD3,8, MProvider #001769024052NPI #: 1780779991301 S 7th StWilliams, AZ 86046(928) 635-4441Hours: M-F 8:00AM-5:00PMHospital Affiliations: MemorialHospital Of South Bend, YavapaiRegional Medical Center West*Yoder, Paul T, MD3,8, MProvider #001769024059NPI #: 17807799912920 N 4th StFlagstaff, AZ 86004(928) 522-6400Hours: M-F 8:00AM-5:00PMHospital Affiliations: MemorialHospital Of South Bend, YavapaiRegional Medical Center West

*Yoder, Paul T, MD3,8, MProvider #001769024060NPI #: 17807799912187 N Vickey St Ste 2Flagstaff, AZ 86004(928) 527-1899Hours: M-F 8:00AM-5:00PMHospital Affiliations: MemorialHospital Of South Bend, YavapaiRegional Medical Center West*Yoder, Paul T, MD3,8, MProvider #001769024065NPI #: 17807799911120 W University AveFlagstaff, AZ 86001(928) 522-1300Hours: M-F 8:00AM-5:00PMHospital Affiliations: MemorialHospital Of South Bend, YavapaiRegional Medical Center West*Zimmerman, Barbara M, MD3,8,FProvider #001529284001NPI #: 1730183278501 N Navajo DrPage, AZ 86040(480) 374-7352Provider Language(s): JapaneseHours: M-F 8:00AM-5:00PMHospital Affiliations: BannerPage Hospital*Zimmerman, Barbara M, MD3,8,FProvider #001529284011NPI #: 1730183278601 N Navajo DrPage, AZ 86040(928) 645-0766Provider Language(s): JapaneseHours: M-F 8:00AM-5:00PMHospital Affiliations: BannerPage Hospital

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ary Care Providers


*Canyonlands Urgent Care1,8Provider #005380531001NPI #: 1669441564440 N Navajo DrPage, AZ 86040(928) 645-1700Hours: M-F 8:00AM-5:00PM*Family Health Center1,8Provider #005038925001NPI #: 10533267511500 E Cedar Ave Ste 266Flagstaff, AZ 86004(928) 773-1245Hours: M-F 8:00AM-5:00PM*Lake Powell Medical Center1,8Provider #005380545001NPI #: 1619945904467 Vista AvePage, AZ 86040(928) 645-8123Hours: M-F 8:00AM-5:00PM*North Country Health-flagst29201,8Provider #005354503001NPI #: 10735834722920 N 4th StFlagstaff, AZ 86004(928) 522-6400Hours: M-F 8:00AM-5:00PM*North Country Health-grand1,8Provider #005347761001NPI #: 18918100241 Clinic RdGrand Canyon, AZ 86023(928) 638-2551Hours: M-F 8:00AM-5:00PM

*North Country Health-grand1,8Provider #005347761002NPI #: 18918100242920 N 4th StFlagstaff, AZ 86004(928) 522-9400Hours: M-F 8:00AM-5:00PM*North Country Health-guidan1,8Provider #005354316001NPI #: 18212288262187 N Vickey St Ste 2Flagstaff, AZ 86004(928) 527-1899Hours: M-F 8:00AM-5:00PM*North Country Health-willia1,8Provider #005354502001NPI #: 1750691788301 S 7th StWilliams, AZ 86046(928) 635-4441Hours: M-F 8:00AM-5:00PM

Internal Medicine

*Abbott, Brandon H, DO3,8, MProvider #005455599004NPI #: 15283501391 Clinic RdGrand Canyon, AZ 86023(928) 638-2551Hours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center*Abbott, Brandon H, DO3,8, MProvider #005455599005NPI #: 1528350139301 S 7th StWilliams, AZ 86046(928) 635-4441Hours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center

*Abbott, Brandon H, DO3,8, MProvider #005455599011NPI #: 15283501392920 N 4th StFlagstaff, AZ 86004(928) 213-6100Hours: M-TH 7:00AM-7:00PMF 7:00AM-6:00PMSA 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center*Abbott, Brandon H, DO3,8, MProvider #005455599012NPI #: 15283501392187 N Vickey St Ste 2Flagstaff, AZ 86004(928) 714-5322Hours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center*Bigler, Jane E, MD8, FProvider #001702999004NPI #: 1285607952107 E Oak Ave Ste 202Flagstaff, AZ 86001(855) 913-8800Provider Language(s): SpanishHours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center*Donnelly, Margaret H, MD3,8, FProvider #001225931005NPI #: 1316924905107 E Oak Ave Ste 201Flagstaff, AZ 86001(855) 913-8800Hours: M-F 8:00AM-5:00PM

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*Donnelly, Margaret H, MD3,8, FProvider #001225931006NPI #: 13169249051200 N Beaver StFlagstaff, AZ 86001(928) 773-2070Hours: M-F 8:00AM-5:00PM*Graham, Lisa A, MD8, FProvider #006020930003NPI #: 13869556231200 N Beaver StFlagstaff, AZ 86001(928) 773-0003Hours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center, Maine MedicalCenter*Knudson, Aaron D, DO3,8, MProvider #003525277006NPI #: 1447417951601 N Navajo DrPage, AZ 86040(928) 645-0766Hours: M-F 8:00AM-5:00PMHospital Affiliations: BannerPage Hospital, BannerThunderbird Medical Center,Dixie Regional Medical Center*Martin, Cynthia E, MD1,3,8, FProvider #002400013005NPI #: 13462909622920 N 4th StFlagstaff, AZ 86004(928) 213-6100Hours: M-TH 7:00AM-7:00PMF 7:00AM-6:00PMSA 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center

*Martin, Cynthia E, MD1,3,8, FProvider #002400013009NPI #: 1346290962301 S 7th StWilliams, AZ 86046(928) 635-4441Hours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center*Martin, Cynthia E, MD1,3,8, FProvider #002400013015NPI #: 13462909622187 N Vickey St Ste 2Flagstaff, AZ 86004(928) 714-5322Hours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center*McReynolds, Joel M, MD3,8, MProvider #002706829006NPI #: 15189413761200 N Beaver StFlagstaff, AZ 86001(928) 213-6415Hours: M-F 8:00AM-5:00PMHospital Affiliations: GhsGreenville Memorial Hospital,Ghs Greenville MemorialMedical Center, Ghs GreerMemorial Hospital, Ghs MarshallI Pickens, Ghs PatewoodMemorial Hospital, PatewoodMemorial Hospital*Newland, Anne M, MD1,3,8, FProvider #002411822001NPI #: 13361789122920 N 4th StFlagstaff, AZ 86004(928) 213-6100Hours: M-F 8:00AM-5:00PM

*Newland, Anne M, MD1,3,8, FProvider #002411822008NPI #: 1336178912301 S 7th StWilliams, AZ 86046(928) 213-6100Hours: M-F 8:00AM-5:00PM*Pico, Mark H, MD3,8, MProvider #002860426007NPI #: 1629284211107 E Oak Ave Ste 201Flagstaff, AZ 86001(928) 913-8800Hours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center, Valley ViewMedical Center, Verde ValleyMedical Center*Pratiti, Rebecca, MD8, FProvider #005620614009NPI #: 19122628742920 N 4th StFlagstaff, AZ 86004(928) 213-6100Provider Language(s): Hindi,Marathi, TamilHours: M-F 8:00AM-5:00PMHospital Affiliations: BannerGateway Medical Center, BannerPayson Medical Center*Raja, Rubina A, MD3,8, FProvider #003161436049NPI #: 18111245301 Clinic RdGrand Canyon, AZ 86023(928) 638-2551Provider Language(s): Hindi,UrduHours: M-F 8:00AM-5:00PMHospital Affiliations: MountainVista Medical Center

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Prim

ary Care Providers

*Raja, Rubina A, MD3,8, FProvider #003161436050NPI #: 1811124530301 S 7th StWilliams, AZ 86046(928) 635-4441Provider Language(s): Hindi,UrduHours: M-F 8:00AM-5:00PMHospital Affiliations: MountainVista Medical Center*Raja, Rubina A, MD3,8, FProvider #003161436056NPI #: 18111245302920 N 4th StFlagstaff, AZ 86004(928) 522-6400Provider Language(s): Hindi,UrduHours: M-F 8:00AM-5:00PMHospital Affiliations: MountainVista Medical Center*Raja, Rubina A, MD3,8, FProvider #003161436057NPI #: 18111245302187 N Vickey St Ste 2Flagstaff, AZ 86004(928) 527-1899Provider Language(s): Hindi,UrduHours: M-F 8:00AM-5:00PMHospital Affiliations: MountainVista Medical Center

*Raja, Rubina A, MD3,8, FProvider #003161436063NPI #: 18111245301120 W University Ave Ste 101Flagstaff, AZ 86001(928) 522-1300Provider Language(s): Hindi,UrduHours: M-F 8:00AM-5:00PMHospital Affiliations: MountainVista Medical Center*Schor, Janett J, MD3,8, FProvider #002125222003NPI #: 16795023551200 N Beaver StFlagstaff, AZ 86001(928) 214-2920Hours: M-F 8:00AM-5:00PM*Scott, Randall P, MD, MProvider #001148219002NPI #: 1235138744715 N Beaver StFlagstaff, AZ 86001(928) 779-5707Hours: M-F 8:00AM-5:00PMHospital Affiliations: WellstarNorth Fulton Hospital*Seby, Mark V, MD1,3,8, MProvider #000561110002NPI #: 1649277492417 N Agassiz St Bldg 1Flagstaff, AZ 86001(928) 779-4200Provider Language(s): FrenchHours: M-F 8:00AM-5:00PMHospital Affiliations: FlagstaffMedical Center


*Alessi, Heidi S, NP8, FProvider #002795160075NPI #: 13261696571000 N Humphreys St Ste 104Flagstaff, AZ 86001(928) 779-3844Hours: SU 11:00AM-5:00PMM-SA 7:00AM-7:00PM*Alessi, Heidi S, NP8, FProvider #002795160076NPI #: 1326169657399 S Malpais Ln Ste 100Flagstaff, AZ 86001(928) 286-8830Hours: SU 11:00AM-5:00PMM-F 8:00AM-5:00PMSA 7:00AM-7:00PM*Boyle, Maureen, NP8, FProvider #003652304004NPI #: 18718338711000 N Humphreys St Ste 104Flagstaff, AZ 86001(928) 779-3844Hours: SU 8:00AM-4:00PMM-F 8:00AM-8:00PMSA 8:00AM-4:00PMHospital Affiliations: St JosephsHospital And Med Center399 S Malpais Ln Ste 100Flagstaff, AZ 86001(928) 286-8830Hours: M-F 8:00AM-5:00PMHospital Affiliations: St JosephsHospital And Med Center

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Arizona - Coconino



*Crump, Jacklynn, NP8Provider #003671117005NPI #: 18618356541000 N Humphreys St Ste 104Flagstaff, AZ 86001(928) 779-3844Hours: SU 11:00AM-5:00PMM-SA 7:00AM-7:00PM*Florea, Kathleen S, NP8, FProvider #002930888001NPI #: 12755277641 Clinic RdGrand Canyon, AZ 86023(928) 638-2551Hours: M-SA 8:00AM-6:00PM*Florea, Kathleen S, NP8, FProvider #002930888004NPI #: 1275527764301 S 7th StWilliams, AZ 86046(928) 635-4441Hours: M-F 8:00AM-5:00PM*Florea, Kathleen S, NP8, FProvider #002930888009NPI #: 12755277642920 N 4th StFlagstaff, AZ 86004(928) 213-6100Hours: M-TH 7:00AM-7:00PMF 8:00AM-5:00PM*Florea, Kathleen S, NP8, FProvider #002930888010NPI #:

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