Get the free 1164414447 EAST VALLEY ENDOSCOPY LLC. 1164414447 EAST VALLEY ENDOSCOPY LLC

WWW.hipaaspace.com. NPI Code Detail ... Entity Type Code, : Organization. Provider ... in HTML format HTML 1750376778 in PDF (Portable Document Format) ...

How to fill out 1164414447 east valley endoscopy

How to fill out 1164414447 East Valley Endoscopy:

1. Begin by gathering all necessary information for the form, such as personal identification details, medical history, and insurance information.
2. Start by writing the date in the designated space on the form.
3. Fill out your full name, address, phone number, and email address in the appropriate sections.
4. Provide your date of birth and gender.
5. If applicable, include your social security number or patient identification number.
6. Indicate your primary care physician's name, address, and contact information.
7. Specify the reason for the endoscopy and any symptoms or concerns you may have.
8. If you have any known allergies, list them accurately on the form.
9. Provide a detailed medical history, including any previous surgeries, current medications, and chronic conditions.
10. If you have any relevant family history of medical conditions, note them on the form.
11. If you have insurance coverage, enter your insurance provider's name, policy number, and group number.
12. If applicable, include any referral details from your doctor or specialist.
13. Sign and date the form at the bottom.
14. Review the completed form to ensure all information is accurate and legible.

Who needs 1164414447 East Valley Endoscopy?

1. Individuals who have been referred by their primary care physician to undergo an endoscopy.
2. People experiencing gastrointestinal symptoms or issues that require further examination.
3. Patients who have a family history of gastrointestinal diseases or conditions.
4. Individuals who have previously undergone endoscopy and require follow-up procedures.
5. Those seeking screening for early detection of gastrointestinal disorders or cancer.
6. Patients who have been experiencing persistent symptoms such as abdominal pain, difficulty swallowing, or unexplained weight loss.
7. People with a history of gastrointestinal bleeding or ulcers.
8. Individuals with a known or suspected digestive tract abnormality or obstruction.
9. Patients who have been diagnosed with inflammatory bowel disease or celiac disease.
10. Those requiring monitoring of a known gastrointestinal condition or treatment efficacy.
11. People with a history of gastrointestinal polyps or tumors.
12. Those in need of a biopsy or tissue sample for further analysis.
13. Individuals with a history of Barrett's esophagus, GERD, or other esophageal disorders.
14. Patients who require removal of foreign objects or strictures in the gastrointestinal tract.

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What is 1164414447 east valley endoscopy?

1164414447 East Valley Endoscopy is a medical facility that specializes in endoscopic procedures.

Who is required to file 1164414447 east valley endoscopy?

The medical facility or its authorized representatives are required to file 1164414447 East Valley Endoscopy.

How to fill out 1164414447 east valley endoscopy?

To fill out 1164414447 East Valley Endoscopy, the required information such as patient details, procedure performed, and billing information must be accurately completed.

What is the purpose of 1164414447 east valley endoscopy?

The purpose of 1164414447 East Valley Endoscopy is to document and report endoscopic procedures conducted at the medical facility.

What information must be reported on 1164414447 east valley endoscopy?

Information such as patient name, date of procedure, type of endoscopy performed, findings, and billing codes must be reported on 1164414447 East Valley Endoscopy.