Active NPI
IV Godzdanker, M.D.
- Emergency Medicine Physician
- Phoenix, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 54281
- Practice address
- 2601 E Roosevelt St
Phoenix, AZ 85008-4973 - Phone
- (602) 344-5808
- Fax
- (602) 344-5907
- NPI assigned
- Jun 3, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Emergency Medicine Physician | 207P00000X | 54281 | AZ | Primary |
Addresses
Primary practice location
2601 E Roosevelt St
Phoenix, AZ 85008-4973
Mailing address
2601 E Roosevelt St
Phoenix, AZ 85008-4973
Other practice location 1
269 S Candy Ln
Cottonwood, AZ 86326-4158
Phone (928) 639-6172
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 774-1693
Hospital & facility affiliations
- Verde Valley Medical Center
- Flagstaff Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 76.21 of 100
- Quality
- 70.63
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.13 of 100
- Quality
- 66.85
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 74.4
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.59 of 100
- Quality
- 81.55
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 79.5
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| District Medical Group, Inc | Current | Accepting new patients | |
| Flagstaff Emergency Physicians | Emergency Medicine | Current | Accepting new patients |
| District Medical Group, Inc | Current | Accepting new patients | |
| District Medical Group, Inc | Emergency Medicine | Current | Accepting new patients |
Locations
269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251
1600 W University Ave
Ste 215
Flagstaff, AZ 86001
Phone (928) 214-3930
1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235
2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298
5102 W Campbell Ave
Phoenix, AZ 85031
Phone (623) 848-5000
3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520
2601 E Roosevelt St
Ste 0D10
Phoenix, AZ 85008
3700 W State Route 89A
Sedona, AZ 86336
Phone (928) 204-3000
3700 W State Route 89A
Ste B
Sedona, AZ 86336
Phone (928) 204-4180
Interoperability endpoints
- igodzdanker78441@direct.valleywisehealth.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 and National Provider Directory roles.
-
- Emergency Medicine Physician
- Flagstaff, AZ
- NPI 1073683991
-
- Anatomic Pathology & Clinical Pathology Physician
- Phoenix, AZ
- NPI 1336472448
-
- Obstetrics & Gynecology Physician
- Phoenix, AZ
- NPI 1083947196
-
- Emergency Medicine Physician
- Phoenix, AZ
- NPI 1144624339
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Psychiatric Hospital Unit
- Flagstaff, AZ
- NPI 1649370875
-
- General Acute Care Hospital
- Flagstaff, AZ
- NPI 1780635078
-
- General Acute Care Hospital
- Cottonwood, AZ
- NPI 1346291648
-
- General Acute Care Hospital
- Sedona, AZ
- NPI 1538608716
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600128000000",
"number": "1104239540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2601 E ROOSEVELT ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850084973"
},
{
"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": "602-344-5808",
"fax_number": "602-344-5907"
}
],
"practiceLocations": [
{
"address_1": "269 S Candy Ln",
"address_purpose": "LOCATION",
"city": "Cottonwood",
"state": "AZ",
"postal_code": "863264158",
"country_code": "US",
"telephone_number": "928-639-6172",
"fax_number": "928-639-6682",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GODZDANKER",
"first_name": "IV",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-03",
"last_updated": "2020-09-15",
"certification_date": "2020-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "AZ",
"license": "54281",
"primary": true
}
],
"identifiers": [],
"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 Sep 15, 2020; 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.