Individual provider Active NPI

Angela Feng

  • Family Medicine Physician
  • Mesa, AZ
National Provider Identifier
1144684036
Registry record updated Jan 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
007936 Issued in AZ
Practice address
1950 S Country Club Dr Ste 101
Mesa, AZ 85210-6044
Phone
(480) 827-5500
Fax
(480) 827-5575
NPI assigned
Apr 7, 2016
Last updated
Jan 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 007936 AZ Primary

Addresses

Primary practice location

1950 S Country Club Dr Ste 101
Mesa, AZ 85210-6044

Mailing address

1950 S Country Club Dr Ste 101
Mesa, AZ 85210-6044
Phone (480) 827-5500

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
I20190712002924 AZ Practitioner - Family Practice 7315235231 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1300 S Country Club Dr
Suite 3
Mesa, AZ 85210-5162
Phone (480) 827-5500

13640 N Plaza del Rio Blvd
Peoria, AZ 85381-4846
Phone (623) 876-3800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
007936AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Childrens Banner Health Clinic LLC CurrentSince Aug 18, 2019 Accepting new patients
Banner Childrens Banner Health Clinic LLC CurrentSince Aug 18, 2019 Accepting new patients
Banner Primary Care Physicians Arizona LLC CurrentSince Mar 1, 2020 Accepting new patients
Banner Primary Care Physicians Arizona LLC Current Accepting new patients
Banner Primary Care Physicians Arizona LLC CurrentSince Mar 1, 2020 Accepting new patients

Locations

1811 E McMurray Blvd
Casa Grande, AZ 85122
Phone (520) 374-2090

17900 N Porter Rd
Maricopa, AZ 85138
Phone (520) 233-2500

1220 S Higley Rd
Ste 101
Mesa, AZ 85206
Phone (480) 615-2010

1300 S Country Club Dr
Ste 3
Mesa, AZ 85210
Phone (480) 827-5500

1450 S Dobson Rd
Ste B220
Mesa, AZ 85202
Phone (480) 827-5044

1950 S Country Club Dr
Ste 101
Mesa, AZ 85210
Phone (480) 557-7474

564 W 9th Pl
Ste 2
Mesa, AZ 85201
Phone (480) 412-6344

117 E Main St
Ste A100
Payson, AZ 85541
Phone (928) 474-1714

13640 N Plaza del Rio Blvd
Peoria, AZ 85381
Phone (623) 876-3800

37100 N Gantzel Rd
Ste 201
San Tan Vly, AZ 85140
Phone (480) 394-4469

14416 W Meeker Blvd
Sun City West, AZ 85375
Phone (623) 583-5083

Organizations & group practices 5

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 2

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": "1459987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1144684036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 S COUNTRY CLUB DR STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852106044",
            "telephone_number": "480-827-5500",
            "fax_number": "480-827-5575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 S COUNTRY CLUB DR STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852106044",
            "telephone_number": "480-827-5500",
            "fax_number": "480-827-5575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENG",
        "first_name": "ANGELA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-07",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "007936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.