Organization Active NPI

Thunderbird Family Medicine LTD

  • Family Medicine Physician
  • Glendale, AZ
National Provider Identifier
1134596174
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
006374 Issued in AZ
Legal business name
THUNDERBIRD FAMILY MEDICINE LTD
Practice address
8608 N 59TH Ave
Glendale, AZ 85302-5404
Phone
(623) 979-2565
Fax
(623) 979-2463
NPI assigned
Aug 25, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Authorized official

Name
Scott Marquard, D.O.NPI 1225399736
Title
Owner
Phone
(602) 979-0309

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 006374 AZ Primary

Addresses

Primary practice location

8608 N 59TH Ave
Glendale, AZ 85302-5404

Mailing address

8608 N 59TH Ave
Glendale, AZ 85302-5404
Phone (623) 979-2565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160108002625 AZ Part B Supplier - Clinic/Group Practice 2365744265 Receives reassigned benefits from 5 practitioners
Practice locations: Glendale, AZ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D0530867Thunderbird Family Medicine8608 N 59TH Ave, Glendale, AZ 85302Certificate of waiverAug 14, 2027

National Provider Directory

National Provider Directory

Locations

5114 W Peoria Ave
Glendale, AZ 85302
Phone (623) 979-0309

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15843/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1440460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722816000000",
    "number": "1134596174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8608 N 59TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853025404",
            "telephone_number": "623-979-2565",
            "fax_number": "623-979-2463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8608 N 59TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853025404",
            "telephone_number": "623-979-2565",
            "fax_number": "623-979-2463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THUNDERBIRD FAMILY MEDICINE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-25",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A",
        "authorized_official_last_name": "MARQUARD",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-979-0309",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "006374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.