Individual provider Active NPI

Mark J Pyle, DO

  • Pediatrics Physician
  • Surprise, AZ
National Provider Identifier
1053536805
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
005244 Issued in AZ
Practice address
15351 W Bell Rd
Surprise, AZ 85374-4580
Phone
(480) 964-2273
Fax
(623) 214-5214
NPI assigned
Apr 16, 2007
Last updated
Apr 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 005244 AZ Primary

Addresses

Primary practice location

15351 W Bell Rd
Surprise, AZ 85374-4580

Mailing address

3033 N Central Ave Ste 145
Phoenix, AZ 85012-2808
Phone (623) 583-3001

Other identifiers 1

IdentifierTypeStateIssuer
430625MedicaidAZ

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
I20121026000716 AZ Practitioner - Pediatric Medicine 4284884222 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Adelante Healthcare, Inc. Family Medicine Current Accepting new patients
Adelante Healthcare, Inc Family Medicine CurrentSince Mar 11, 2024 Accepting new patients
Adelante Healthcare, Inc CurrentSince Mar 11, 2024 Accepting new patients
Adelante Healthcare, Inc. Family Medicine Past Accepting new patients

Locations

1705 W Main St
Mesa, AZ 85201
Phone (480) 845-6769

15525 N 83rd Ave
Ste 104
Peoria, AZ 85382

3033 N Central Ave
Ste 145
Phoenix, AZ 85012

9610 N Metro Pkwy W
Phoenix, AZ 85051
Phone (602) 843-1560

15317 W Bell Rd
Ste 100
Surprise, AZ 85374

15351 W Bell Rd
Surprise, AZ 85374

811 N Tegner St
Ste 113
Wickenburg, AZ 85390

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1053536805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 N CENTRAL AVE STE 145",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122808",
            "telephone_number": "623-583-3001",
            "fax_number": "623-974-6721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15351 W BELL RD",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853744580",
            "telephone_number": "480-964-2273",
            "fax_number": "623-214-5214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PYLE",
        "first_name": "MARK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "005244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "430625",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

Verify at the official NPI Registry.