Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Nickey R O'Coyne Jr., MD

Individual provider Internal Medicine Physician · NPI 1417275348

Nickey R O'Coyne Jr., MD is an Internal Medicine in Peoria, Arizona. Qualified in 2010, 16 years ago. Practices with Banner Primary Care Physicians Arizona LLC, a 237-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Arizona.

Years since qualifying
16
Licensed in
AZ
In the registry since
2010
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

13640 N Plaza Del Rio Blvd Ste 350
Peoria, AZ 85381-4846
Phone: (623) 876-8600
Fax: (623) 876-6992
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 44435 (AZ)

Record details

NPI number1417275348
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 17, 2010
Last updated in NPPESJune 29, 2025
Certification dateJune 29, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Banner Primary Care Physicians Arizona Llc — 237 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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