Individual provider Active NPI

Rebecca M Branaman, M.D.

  • Obstetrics & Gynecology Physician
  • Peoria, AZ
National Provider Identifier
1144289232
Registry record updated Mar 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
29224 Issued in AZ
Practice address
15396 N 83Rd Ave
Suite F-100
Peoria, AZ 85381-5622
Phone
(602) 595-9696
Fax
(623) 412-9123
NPI assigned
Mar 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 29224 AZ Primary

Addresses

Primary practice location

15396 N 83Rd Ave
Suite F-100
Peoria, AZ 85381-5622

Mailing address

PO Box 10967
Glendale, AZ 85318-0967
Phone (602) 595-9696

Other identifiers 1

IdentifierTypeStateIssuer
578635MedicaidAZ

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
I20041027001041 AZ Practitioner - Obstetrics/Gynecology 4183686694 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Kansas School of Med (KC/Wich/Sal), 1997
Medicare assignment
May accept Medicare assignment
Group practices
Pinnacle Women'S Center LLCGroup PAC ID 2567707813, 2 clinicians

Practice addresses (Care Compare)

15396 N 83Rd Ave
Suite F100
Peoria, AZ 85381-5629
Phone (602) 595-9696

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29224AZMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Women'S Center LLC Obstetrics & Gynecology CurrentSince Feb 21, 2017 Accepting new patients
Banner Thunderbird Medical Center Past Accepting new patients
Glendale Obstetrics and Gynecology PC Obstetrics & Gynecology PastSince Sep 1, 2009 Accepting new patients

Locations

15396 N 83rd Ave
Ste F100
Peoria, AZ 85381
Phone (602) 595-9696

Interoperability endpoints

  • Direct secure messaging: rebecca.branaman@az028.digichart.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489708800000",
    "number": "1144289232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10967",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853180967",
            "telephone_number": "602-595-9696",
            "fax_number": "623-412-9123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15396 N 83RD AVE",
            "address_2": "SUITE F-100",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815622",
            "telephone_number": "602-595-9696",
            "fax_number": "623-412-9123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANAMAN",
        "first_name": "REBECCA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-20",
        "last_updated": "2017-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "29224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "578635",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.