Individual provider Active NPI

Redentor T Espiritu, MD

  • Family Medicine Physician
  • Peoria, AZ
National Provider Identifier
1053303065
Registry record updated Sep 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
31859 Issued in AZ
Practice address
7147 W Softwind Dr
Peoria, AZ 85383
Phone
(623) 444-4351
Fax
(623) 234-9932
NPI assigned
Aug 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 31859 AZ Primary

Addresses

Primary practice location

7147 W Softwind Dr
Peoria, AZ 85383

Mailing address

7147 W Softwind Dr
Peoria, AZ 85383-3247
Phone (623) 444-4351

Other identifiers 1

IdentifierTypeStateIssuer
Z124234OtherAZPTAN

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
I20040226000934 AZ Practitioner - Family Practice 4587550397 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
31859AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospice of Stars Inc Family Medicine CurrentSince Nov 27, 2022 Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
True North HospicePhoenix, AZ, CCN 031771 Hospice Contracted Managing Employee Sep 1, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536105600000",
    "number": "1053303065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7147 W SOFTWIND DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853833247",
            "telephone_number": "623-444-4351",
            "fax_number": "623-234-9932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7147 W SOFTWIND DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "85383",
            "telephone_number": "623-444-4351",
            "fax_number": "623-234-9932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPIRITU",
        "first_name": "REDENTOR",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2018-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "31859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "Z124234",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.