Synthia Puffenberger, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

4573 Issued in AZ

Practice address

1920 E Cambridge Ave Ste 301
Phoenix, AZ 85006-1464

Phone

(602) 933-0935

Fax

(602) 933-2471

NPI assigned

Sep 11, 2009

Last updated

Mar 26, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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

• Phoenix Children's Hospital

  dba Phoenix Children's Medical Group

  • Pediatrics Physician
  • Phoenix, AZ
  • NPI 1922112044
  Medicare reassignment NPD
• Phoenix Children's Medical Group

  • Multi-Specialty Clinic/Center
  • Mesa, AZ
  • NPI 1487814240
  NPD
• Phoenix Children's Hospital Hope

  • Pharmacy
  • Phoenix, AZ
  • NPI 1386749836
  NPD (past)
• Nationwide Children's Hospital

  • Dental Clinic/Center
  • Columbus, OH
  • NPI 1407013964
  NPD (past)

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

{
    "created_epoch": "1252627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522022400000",
    "number": "1043543812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 E CAMELBACK RD STE 250",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182327",
            "telephone_number": "602-933-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 E CAMBRIDGE AVE STE 301",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850061464",
            "telephone_number": "602-933-0935",
            "fax_number": "602-933-2471"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "899 E Broad St",
            "address_2": "3RD FLOOR",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432051156",
            "country_code": "US",
            "telephone_number": "614-355-8000",
            "fax_number": "614-355-8018",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1920 E Cambridge Ave Ste 301",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850061464",
            "country_code": "US",
            "telephone_number": "602-933-0935",
            "fax_number": "602-933-2471",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "899 E Broad St",
            "address_2": "3RD FLOOR",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432051156",
            "country_code": "US",
            "telephone_number": "614-355-8000",
            "fax_number": "614-355-8018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUFFENBERGER",
        "first_name": "SYNTHIA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-11",
        "last_updated": "2018-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "AZ",
            "license": "4573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08258",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pueblo Family Physicians LTD
• Pueblo Radiology, LLC (Canyon Medical Imaging)
• Lysbeth Puente
• Marcos C. Puente, PHARMD
• Sarah Elizabeth Puente, DC
• Eric Gilbert Puga, MS CCC-SLP
• Anne Elizabeth Puggini, NP
• Tracey Pugh, NP
• Julie Pugliese, FNP-C
• Susan Puglisi, PHARMD

• Clinical Child & Adolescent Psychologist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Clinical Child & Adolescent Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.