Individual provider Active NPI

Ashley Pearl Gray-Zlotnick

  • Pediatrics Physician
  • Phoenix, AZ
National Provider Identifier
1134461346
Registry record updated Aug 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
52051 Issued in AZ
Practice address
2510 W Dunlap Ave
Ste 290
Phoenix, AZ 85021-2737
Phone
(602) 789-0344
Fax
(602) 789-8389
NPI assigned
Mar 26, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 52051 AZ Primary

Addresses

Primary practice location

2510 W Dunlap Ave
Ste 290
Phoenix, AZ 85021-2737

Mailing address

2510 W Dunlap Ave
Ste 290
Phoenix, AZ 85021-2737
Phone (602) 789-0344

Other identifiers 1

IdentifierTypeStateIssuer
153208MedicaidAZ

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
I20160830001945 AZ Practitioner - Pediatric Medicine 4082909064 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52051AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Physician Super Specialists Arizona LLC CurrentSince Jan 1, 2018 Accepting new patients
Arizona Acute Medical Services 1 PC CurrentSince Apr 1, 2017 Accepting new patients
Banner Physician Super Specialists Arizona LLC CurrentSince Jan 1, 2018 Accepting new patients
Arizona Post-Acute Medical Services 1 PC Past Accepting new patients
Banner Desert Medical Center Past Accepting new patients
Banner del E Webb Medical Center Past Accepting new patients
Banner Gateway Medical Center Past Accepting new patients

Locations

1900 N Higley Rd
Gilbert, AZ 85234
Phone (480) 543-2000

1432 S Dobson Rd
Ste 509
Mesa, AZ 85202
Phone (480) 412-6970

1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000

1450 S Dobson Rd
Ste B221
Mesa, AZ 85202
Phone (480) 461-1161

6644 E Baywood Ave
Mesa, AZ 85206
Phone (480) 321-2000

1432 S Dobson Rd
Ste 301
Mesa, AZ 85202
Phone (480) 412-7120

2510 W Dunlap Ave
Ste 290
Phoenix, AZ 85021

3929 E Bell Rd
Phoenix, AZ 85032
Phone (602) 923-5000

1921 W Hospital Dr
Tucson, AZ 85704
Phone (520) 544-5200

Organizations & group practices 7

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": "1364256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470787200000",
    "number": "1134461346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 W DUNLAP AVE",
            "address_2": "STE 290",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850212737",
            "telephone_number": "602-789-0344",
            "fax_number": "602-789-8389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 W DUNLAP AVE",
            "address_2": "STE 290",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850212737",
            "telephone_number": "602-789-0344",
            "fax_number": "602-789-8389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY-ZLOTNICK",
        "first_name": "ASHLEY",
        "middle_name": "PEARL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-26",
        "last_updated": "2016-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "52051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153208",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.