Individual provider Active NPI

Konstantin Mazursky, D.O

  • Hospitalist Physician
  • Casa Grande, AZ
National Provider Identifier
1033559554
Registry record updated Dec 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
006870 Issued in AZ
Practice address
1800 E Florence Blvd
Attn: Hospitalist Team
Casa Grande, AZ 85122-5303
Phone
(480) 543-2034
Fax
(480) 543-2647
NPI assigned
Jun 28, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 006870 AZ
Internal Medicine Physician 207R00000X R2317 AZ
Hospitalist Physician 208M00000X 006870 AZ Primary

Addresses

Primary practice location

1800 E Florence Blvd
Attn: Hospitalist Team
Casa Grande, AZ 85122-5303

Mailing address

1800 E Florence Blvd
Attn: Hospitalist Team
Casa Grande, AZ 85122-5303
Phone (480) 543-2034

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160809001080 AZ Practitioner - Internal Medicine 4183918428 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner Hospital Based Physicians Arizona LLCGroup PAC ID 3274782487, 636 clinicians

Practice addresses (Care Compare)

1800 E Florence Blvd
Casa Grande, AZ 85122-5303
Phone (520) 381-6300

Hospital & facility affiliations

  • Banner Ironwood Medical Center Hospital, Queen Creek, AZ, CCN 030130
  • Banner Goldfield Medical Center Hospital, Apache Junction, AZ, CCN 030134
  • Banner Casa Grande Medical Center Hospital, Casa Grande, AZ, CCN 030016
  • Banner Desert Medical Center Hospital, Mesa, AZ, CCN 030065

Merit-based Incentive Payment System (MIPS)

Final score
83.7 of 100Reported as group
Quality
64.97
Promoting interoperability
98
Improvement activities
40
Cost
69.88

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R2317AZMDInternal Medicine Physician
006870AZMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Oct 1, 2017 Accepting new patients
Banner Hospital Based Physicians Arizona LLC Current Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Oct 1, 2017 Accepting new patients
Banner Desert Medical Center Past Accepting new patients
Banner Goldfield Medical Center Past Accepting new patients
Banner Health Past Accepting new patients
Banner Ironwood Medical Center Past Accepting new patients

Locations

2050 W Southern Ave
Apache Junction, AZ 85120
Phone (480) 237-3200

1800 E Florence Blvd
Casa Grande, AZ 85122
Phone (520) 381-6285

1900 N Higley Rd
Gilbert, AZ 85234
Phone (480) 543-2000

6644 E Baywood Ave
Mesa, AZ 85206
Phone (480) 321-2000

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

37000 N Gantzel Rd
San Tan Valley, AZ 85140
Phone (480) 394-4000

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1372377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546214400000",
    "number": "1033559554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 E FLORENCE BLVD",
            "address_2": "ATTN: HOSPITALIST TEAM",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851225303",
            "telephone_number": "480-543-2034",
            "fax_number": "480-543-2647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 E FLORENCE BLVD",
            "address_2": "ATTN: HOSPITALIST TEAM",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851225303",
            "telephone_number": "480-543-2034",
            "fax_number": "480-543-2647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZURSKY",
        "first_name": "KONSTANTIN",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-28",
        "last_updated": "2018-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "006870",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "R2317",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AZ",
            "license": "006870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casa Grande, AZ

Sources for this page

Verify at the official NPI Registry.