Pebble Creek Medical Group PLLC
NPI 1790213064 · Internal Medicine Physician · Goodyear, AZ
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Pebble Creek Medical Group PLLC is a Internal Medicine Physician organization in Goodyear, AZ (NPI 1790213064).
Provider details
- NPI number
- 1790213064
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Sanjay Bommakanti, Md/Owner(623) 337-6897
- License
- 37252 (AZ)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2017-05-31
- Last updated
- 2017-05-31
Frequently asked questions
- What is Pebble Creek Medical Group PLLC's NPI number?
- Pebble Creek Medical Group PLLC's National Provider Identifier (NPI) is 1790213064, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Pebble Creek Medical Group PLLC?
- Pebble Creek Medical Group PLLC is classified in the NPPES registry as Internal Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Pebble Creek Medical Group PLLC located?
- Pebble Creek Medical Group PLLC's practice location on file with NPPES is 700 N Estrella Pkwy # 130, Goodyear, AZ 85338-9271.
- What is Pebble Creek Medical Group PLLC's phone number?
- The practice phone number listed in the NPPES registry for Pebble Creek Medical Group PLLC is (623) 322-2144.
- Does Pebble Creek Medical Group PLLC accept Medicare?
- Pebble Creek Medical Group PLLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Pebble Creek Medical Group PLLC?
- The authorized official listed on Pebble Creek Medical Group PLLC's NPPES record is Sanjay Bommakanti, Md/Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Pebble Creek Medical Group PLLC's NPI active?
- Yes — Pebble Creek Medical Group PLLC's NPI (1790213064) is active in the NPPES registry as of the last update on 2017-05-31.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.