Individual provider Active NPI

Ryan Daniel Bangart, DPM

  • Foot & Ankle Surgery Podiatrist
  • Peoria, AZ
National Provider Identifier
1104342781
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
POD-000975 Issued in AZ
Practice address
13660 N 94TH Dr Ste D1
Peoria, AZ 85381-4836
Phone
(623) 974-0522
Fax
(623) 933-5787
NPI assigned
Aug 16, 2017
Last updated
Feb 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X POD-000975 AZ
Foot & Ankle Surgery Podiatrist 213ES0103X POD-000975 AZ Primary

Addresses

Primary practice location

13660 N 94TH Dr Ste D1
Peoria, AZ 85381-4836

Mailing address

13660 N 94TH Dr Ste D1
Peoria, AZ 85381-4836
Phone (623) 974-0522

Other practice location 1

490 W Bralliar Rd
Wickenburg, AZ 85390-2448
Phone (928) 684-0219

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
I20201106001228 AZ Practitioner - Podiatry 9931529492 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alliance Medical Specialists PLLCGroup PAC ID 3072047174, 2 clinicians

Practice addresses (Care Compare)

13660 N 94TH Dr
Suite D1
Peoria, AZ 85381-4275
Phone (623) 215-2541

13660 N 94TH Dr
Suite D1
Peoria, AZ 85381-4836
Phone (623) 974-0522

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue112
Removal of skin lesions146
Removal of nail tissue481
Removal or shaving of skin growth228
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
POD-000975AZMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ryan Bangart DPM PC Podiatrist CurrentSince Apr 16, 2020 Accepting new patients
Alliance Medical Specialists, PLLC Podiatrist CurrentSince Sep 28, 2024 Accepting new patients

Locations

13660 N 94th Dr
Ste D1
Peoria, AZ 85381
Phone (623) 230-2912

490 W Bralliar Rd
Wickenburg, AZ 85390
Phone (623) 974-0522

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1502841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1104342781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13660 N 94TH DR STE D1",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814836",
            "telephone_number": "623-974-0522",
            "fax_number": "623-933-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13660 N 94TH DR STE D1",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814836",
            "telephone_number": "623-974-0522",
            "fax_number": "623-933-5787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "490 W Bralliar Rd",
            "address_purpose": "LOCATION",
            "city": "Wickenburg",
            "state": "AZ",
            "postal_code": "853902448",
            "country_code": "US",
            "telephone_number": "928-684-0219",
            "fax_number": "623-933-5787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANGART",
        "first_name": "RYAN",
        "middle_name": "DANIEL",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-16",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "AZ",
            "license": "POD-000975",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AZ",
            "license": "POD-000975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.