Individual provider Active NPI

Eric M Ossowski, M.D.

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1063508463
Registry record updated Jul 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
AZ #12127 Issued in AZ
Practice address
4212 N 16TH Street
Phoenix Indian Medical Center
Phoenix, AZ 85016-5319
Phone
(602) 263-1511
Fax
(602) 263-1619
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2011

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X AZ #12127 AZ Primary
Family Medicine Physician 207Q00000X MN#24356 MN
Geriatric Medicine (Family Medicine) Physician 207QG0300X AZ #12127 AZ
Geriatric Medicine (Family Medicine) Physician 207QG0300X MN#24356 MN

Addresses

Primary practice location

4212 N 16TH Street
Phoenix Indian Medical Center
Phoenix, AZ 85016-5319

Mailing address

PO Box 31001-0698
Pasadena, CA 91110-0698
Phone (602) 263-1511

Other identifiers 2

IdentifierTypeStateIssuer
AZ0713230OtherAZBCBS
414160MedicaidAZ

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
I20160725000789 AZ Practitioner - Family Practice 2163459512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota, Duluth School of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Circle the CityGroup PAC ID 3971824442, 63 clinicians

Practice addresses (Care Compare)

210 S 12TH Ave
Phoenix, AZ 85007-3101
Phone (602) 254-4282

220 S 12TH Ave
Phoenix, AZ 85007-3101
Phone (602) 258-8282

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AZ #12127AZMDFamily Medicine Physician
MN#24356MNMDFamily Medicine Physician
12127AZMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Circle the City CurrentSince Jun 5, 2016 Accepting new patients
Circle the City CurrentSince Jun 5, 2016 Accepting new patients
Circle the City Family Medicine Current Accepting new patients

Locations

300 W Clarendon Ave
Ste 200
Phoenix, AZ 85013
Phone (602) 776-0776

3522 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 776-7676

333 W Indian School Rd
Phoenix, AZ 85013
Phone (602) 248-0368

Interoperability endpoints

  • Direct secure messaging: eric.ossowski.1@11818.direct.athenahealth.com
  • Direct secure messaging: eric.ossowski.1@5919.direct.athenahealth.com

Organizations & group practices 3

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311638400000",
    "number": "1063508463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31001-0698",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911100698",
            "telephone_number": "602-263-1511",
            "fax_number": "602-263-1619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4212 N 16TH STREET",
            "address_2": "PHOENIX INDIAN MEDICAL CENTER",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165319",
            "telephone_number": "602-263-1511",
            "fax_number": "602-263-1619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSSOWSKI",
        "first_name": "ERIC",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2011-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "AZ #12127",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "MN#24356",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "AZ",
            "license": "AZ #12127",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "MN",
            "license": "MN#24356",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0713230",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "414160",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.