Individual provider Active NPI

Bryan Paul Mahoney, DO

  • Internal Medicine Physician
  • Glendale, AZ
National Provider Identifier
1033615901
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
009148 Issued in AZ
Practice address
7701 W Aspera Blvd
Glendale, AZ 85308-7947
Phone
(623) 465-6060
Fax
(623) 242-5833
NPI assigned
Apr 1, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X AZ
Internal Medicine Physician 207R00000X 009148 AZ Primary

Addresses

Primary practice location

7701 W Aspera Blvd
Glendale, AZ 85308-7947

Mailing address

7701 W Aspera Blvd
Glendale, AZ 85308-7947

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
I20210826002138 AZ Practitioner - Internal Medicine 9537564745 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Arizona College of Osteopathic Medicine Mid Western University, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Banner Primary Care Physicians Arizona LLCGroup PAC ID 6406020155, 236 clinicians
BHSM Rehabilitation LLCGroup PAC ID 2062773138, shared by 27 NPIs, 450 clinicians

Practice addresses (Care Compare)

13640 N Plaza del Rio Blvd
Peoria, AZ 85381-4846
Phone (623) 876-3800

25101 N Lake Pleasant Pkwy
Suite B 1340
Peoria, AZ 85383-1386
Phone (602) 610-6866

7701 W Aspera Blvd
Suite 102 201 301
Glendale, AZ 85308-7935
Phone (623) 248-2100

Hospital & facility affiliations

  • Banner Home Care-Arizona Home health agency, Mesa, AZ, CCN 037015
  • Banner del E. Webb Medical Center Hospital, Sun City West, AZ, CCN 030093

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
009148AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Primary Care Physicians Arizona LLC CurrentSince Aug 29, 2021 Accepting new patients
Banner Primary Care Physicians Arizona LLC CurrentSince Aug 29, 2021 Accepting new patients
Banner Primary Care Physicians Arizona LLC Current Accepting new patients
Banner Physician Specialists Arizona LLC PastSince Sep 14, 2025 Accepting new patients
Banner Primary Care Physicians Arizona LLC PastSince Sep 14, 2025 Accepting new patients

Locations

13640 N Plaza del Rio Blvd
Peoria, AZ 85381
Phone (623) 876-3800

Organizations & group practices 5

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 2

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": "1522540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1033615901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7701 W ASPERA BLVD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853087947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7701 W ASPERA BLVD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853087947",
            "telephone_number": "623-465-6060",
            "fax_number": "623-242-5833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHONEY",
        "first_name": "BRYAN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-01",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "009148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.