Provider Demographics
NPI:1992885545
Name:JAO, GEOFFREY TE (MD)
Entity type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:TE
Last Name:JAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 W UTOPIA RD STE 100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-4172
Mailing Address - Country:US
Mailing Address - Phone:623-683-4462
Mailing Address - Fax:623-682-4963
Practice Address - Street 1:10210 N 92ND ST STE 300
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4525
Practice Address - Country:US
Practice Address - Phone:480-882-7750
Practice Address - Fax:808-825-8384
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2007-00528207RA0001X, 207R00000X, 207RC0000X, 208M00000X
NY002717207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC810599OtherPARTNERS
NC199206OtherMEDCOST
WV3810009020Medicaid
NC5906676Medicaid
NC145HTOtherBCBS
VA1992885545Medicaid
NC9164064OtherAETNA
SCQ0052MMedicaid
NC810599OtherPARTNERS
WV3810009020Medicaid
NC145HTOtherBCBS
NCP00416730Medicare PIN
I70788Medicare UPIN