Individual provider Active NPI

Eric Pittman, MD

  • Hospitalist Physician
  • Mesa, AZ
National Provider Identifier
1063472249
Registry record updated Oct 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
30757 Issued in AZ
Practice address
6644 E Baywood Ave
Banner Baywood Medical Center
Mesa, AZ 85206
Phone
(480) 321-3900
Fax
(480) 321-3840
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 30757 AZ
Hospitalist Physician 208M00000X 30757 AZ Primary

Addresses

Primary practice location

6644 E Baywood Ave
Banner Baywood Medical Center
Mesa, AZ 85206

Mailing address

6644 E Baywood Ave
Banner Baywood Medical Center
Mesa, AZ 85206
Phone (480) 321-3900

Other identifiers 3

IdentifierTypeStateIssuer
AZ0740040OtherAZBCBS
P00059189OtherAZRR MEDICARE
74591104MedicaidAZ

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
I20040512000953 AZ Practitioner - Internal MedicinePractitioner - Hospitalist 7810987914 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30757AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Cancer Center Specialists LLC CurrentSince Apr 1, 2020 Accepting new patients
Banner Cancer Center Specialists LLC CurrentSince Apr 1, 2020 Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Aug 1, 2015 Accepting new patients
Banner Hospital Based Physicians Arizona LLC Current Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Aug 1, 2015 Accepting new patients
Sun Health Corporation Past Accepting new patients

Locations

1900 N Higley Rd
Gilbert, AZ 85234
Phone (480) 543-2000

2946 E Banner Gateway Dr
Gilbert, AZ 85234
Phone (480) 256-5450

6644 E Baywood Ave
Mesa, AZ 85206
Phone (480) 321-2000

6750 E Baywood Ave
Mesa, AZ 85206
Phone (480) 854-5000

807 S Ponderosa St
Payson, AZ 85541
Phone (520) 474-3222

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

Organizations & group practices 6

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": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444089600000",
    "number": "1063472249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6644 E BAYWOOD AVE",
            "address_2": "BANNER BAYWOOD MEDICAL CENTER",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85206",
            "telephone_number": "480-321-3900",
            "fax_number": "480-321-3840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6644 E BAYWOOD AVE",
            "address_2": "BANNER BAYWOOD MEDICAL CENTER",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85206",
            "telephone_number": "480-321-3900",
            "fax_number": "480-321-3840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITTMAN",
        "first_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2015-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "30757",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AZ",
            "license": "30757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0740040",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00059189",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74591104",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.