Individual provider Active NPI

Evelyn Heigh-Rosen, D.P.M.

  • Podiatrist
  • Glendale, AZ
National Provider Identifier
1073933826
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
847 Issued in AZ
Practice address
5620 W Thunderbird Rd
Glendale, AZ 85306-4636
Phone
(602) 938-6960
Fax
(602) 938-6069
NPI assigned
Apr 20, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 847 AZ Primary
Foot & Ankle Surgery Podiatrist 213ES0103X 847 AZ

Addresses

Primary practice location

5620 W Thunderbird Rd
Glendale, AZ 85306-4636

Mailing address

5620 W Thunderbird Rd Ste G2
Glendale, AZ 85306-4652
Phone (886) 986-7278

Other identifiers 1

IdentifierTypeStateIssuer
NAOtherN/A

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Glendale

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180629002580 AZ Practitioner - Podiatry 6901171792 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Arizona College of Osteopathic Medicine Mid Western University, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwestern UniversityGroup PAC ID 6305734773, 116 clinicians

Practice addresses (Care Compare)

19389 N 59TH Ave
Glendale, AZ 85308-6500
Phone (623) 537-6000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue49
Removal of nail tissue178
Removal or shaving of skin growth73

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5320CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group Arizona LLC Podiatrist CurrentSince Jan 28, 2019 Accepting new patients
Midwestern University Podiatrist CurrentSince Mar 28, 2022 Accepting new patients
Midwestern University CurrentSince Mar 28, 2022 Accepting new patients
University Foot and Ankle Institute a Podiatric Surgical Center Podiatrist Past Accepting new patients

Locations

5620 W Thunderbird Rd
Ste F1
Glendale, AZ 85306
Phone (602) 938-6960

5620 W Thunderbird Rd
Ste G2
Glendale, AZ 85306
Phone (602) 938-3600

19389 N 59th Ave
Glendale, AZ 85308

19555 N 59th Ave
Glendale, AZ 85308
Phone (623) 572-3200

14541 W Indian School Rd
#600
Goodyear, AZ 85395
Phone (623) 535-5599

14418 W Meeker Blvd
Ste 110
Sun City West, AZ 85375
Phone (623) 377-7410

26520 Network Pl
Chicago, IL 60673
Phone (630) 743-4500

Interoperability endpoints

  • Direct secure messaging: eheighrosen18709@direct.midwestern.edu

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1397952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1073933826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5620 W THUNDERBIRD RD STE G2",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064652",
            "telephone_number": "886-986-7278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5620 W THUNDERBIRD RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064636",
            "telephone_number": "602-938-6960",
            "fax_number": "602-938-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIGH-ROSEN",
        "first_name": "EVELYN",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-20",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "AZ",
            "license": "847",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AZ",
            "license": "847",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "N/A",
            "identifier": "NA",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Glendale",
            "affiliation": "N",
            "address_1": "5620 W Thunderbird Rd",
            "city": "Glendale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853064636",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.