Active NPI
Gregory J Fenzl, D.O.
- Diagnostic Radiology Physician
- Phoenix, AZ
National Provider Identifier
1093787004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 4043
- Practice address
- 19829 N 27TH Ave
Phoenix, AZ 85027-4001 - Phone
- (623) 879-5720
- NPI assigned
- Feb 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 4043 | AZ | Primary |
Addresses
Primary practice location
19829 N 27TH Ave
Phoenix, AZ 85027-4001
Mailing address
10835 N 25TH Ave
Ste 240
Phoenix, AZ 85029-3458
Phone (602) 943-9200
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 857568 | Medicaid | AZ | |
| 1Z7086 | Other | AZ | HEALTH NET OF ARIZONA |
| AZ0221810 | Other | AZ | BCBSAZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4043 | AZ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sjhmc Physician Services | Past | Accepting new patients | |
| Ultimate Urgent Care Centers | Past | Accepting new patients | |
| Mdig of New Mexico, LLC | Diagnostic Radiology | Past | Accepting new patients |
| Cincinnati Imaging Leasing Company, LTD. | Diagnostic Radiology | Past | Accepting new patients |
Interoperability endpoints
- gehgfenzl@yourcarecommunity.org
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.
-
- Diagnostic Radiology Physician
- Phoenix, AZ
- NPI 1225524531
-
dba St. Joseph's Faculty Physicians
- Multi-Specialty Clinic/Center
- Phoenix, AZ
- NPI 1326098005
-
- Urgent Care Clinic/Center
- Peoria, AZ
- NPI 1356547798
-
dba ProScan Imaging Midtown
- Diagnostic Radiology Physician
- Cincinnati, OH
- NPI 1447240502
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502236800000",
"number": "1093787004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10835 N 25TH AVE",
"address_2": "STE 240",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850293458",
"telephone_number": "602-943-9200",
"fax_number": "602-216-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19829 N 27TH AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850274001",
"telephone_number": "623-879-5720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FENZL",
"first_name": "GREGORY",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-03",
"last_updated": "2017-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "AZ",
"license": "4043",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "857568",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET OF ARIZONA",
"identifier": "1Z7086",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSAZ",
"identifier": "AZ0221810",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.