Individual provider Active NPI

Dana Alesse Jamison, M.D.

  • Orthopaedic Surgery Physician
  • Phoenix, AZ
National Provider Identifier
1124117585
Registry record updated Feb 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
23481 Issued in AZ
Practice address
1012 E Willetta St
Phoenix, AZ 85006-2749
Phone
(602) 239-6040
Fax
(602) 239-6372
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X G79311 CA
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X 23481 AZ
Orthopaedic Surgery Physician 207X00000X 23481 AZ Primary

Addresses

Primary practice location

1012 E Willetta St
Phoenix, AZ 85006-2749

Mailing address

9393 N 90TH St
Suite # 102-130
Scottsdale, AZ 85258-5040
Phone (602) 361-1191

Other identifiers 1

IdentifierTypeStateIssuer
322967MedicaidAZ

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
I20040407000491 AZ Practitioner - Orthopedic SurgeryPractitioner - Other (Physician)Practitioner - Undersea and Hyperbaric Medicine 1355334178 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23481AZMDOrthopaedic Surgery Physician
G79311CAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Center for Orthopaedics and Sports Medicine PC Orthopaedic Surgery CurrentSince Jun 28, 2013 Accepting new patients

Locations

1800 E Florence Blvd
Casa Grande, AZ 85122
Phone (520) 381-6285

1012 E Willetta St
Phoenix, AZ 85006
Phone (602) 239-6040

9393 N 90th St
Scottsdale, AZ 85258
Phone (480) 420-8204

9393 N 90th St
Ste 102130
Scottsdale, AZ 85258

9393 N 90th St
#130
Scottsdale, AZ 85258
Phone (602) 361-1191

Organizations & group practices 1

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581638400000",
    "number": "1124117585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9393 N 90TH ST",
            "address_2": "SUITE # 102-130",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852585040",
            "telephone_number": "602-361-1191",
            "fax_number": "480-905-1695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 E WILLETTA ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062749",
            "telephone_number": "602-239-6040",
            "fax_number": "602-239-6372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMISON",
        "first_name": "DANA",
        "middle_name": "ALESSE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G79311",
            "primary": false
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "AZ",
            "license": "23481",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "23481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "322967",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.