Michael Lorin Hibbard, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

81482 Issued in AZ

Practice address

2601 E Roosevelt St
Phoenix, AZ 85008-4973

Phone

(602) 344-5445

NPI assigned

May 24, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

General Surgery

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Permanente Medical GroupGroup PAC ID 6002729175, shared by 4 NPIs, 11,250 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Riverside, CA
  • NPI 1316979834
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Fontana, CA
  • NPI 1689606196
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Anaheim, CA
  • NPI 1952333460
  NPD
• Center for Physical Medicine & Rehabilitation P C

  • Physical Medicine & Rehabilitation Physician
  • Phoenix, AZ
  • NPI 1306959218
  NPD (past)
• Med 97 LLC

  dba Advanced Urgent Care

  • Urgent Care Clinic/Center
  • Phoenix, AZ
  • NPI 1487631883
  NPD (past)

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

{
    "created_epoch": "1211587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1053579235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4033 W SHARON AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850291045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 E ROOSEVELT ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850084973",
            "telephone_number": "602-344-5445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIBBARD",
        "first_name": "MICHAEL",
        "middle_name": "LORIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-24",
        "last_updated": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "81482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6041 Cadillac Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900341702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Beril Hezer, MS, RD
• HGL Corporation (Northwest Medical Center)
• HH Helping Hands LLC
• Hi Phoenix, LLC (Home Instead Senior Care)
• Jamila G Hiasat, MD
• Braxton Hibbert
• Diane Hibbs, D.O.
• Aleksandra Maria Hibner
• Alison Hibner, RD
• Michael Hibner, M.D.

• Surgery Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.