Individual provider Active NPI

Bruce R Werber, DPM

  • Foot & Ankle Surgery Podiatrist
  • Scottsdale, AZ
National Provider Identifier
1154315174
Registry record updated Jul 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
624 Issued in AZ
Practice address
9188 E San Salvador Dr
Suite 201
Scottsdale, AZ 85258-5562
Phone
(602) 405-3247
Fax
(888) 232-6750
NPI assigned
Sep 6, 2005
Last updated
Jul 21, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X DPM00200 RI
Foot & Ankle Surgery Podiatrist 213ES0103X 624 AZ Primary

Addresses

Primary practice location

9188 E San Salvador Dr
Suite 201
Scottsdale, AZ 85258-5562

Mailing address

4782 N 53Rd St
Phoenix, AZ 85018-1955
Phone (602) 750-1146

Other identifiers 4

IdentifierTypeStateIssuer
961202MedicaidAZ
21286-7OtherRIB/C & B/S OF RI
7005207MedicaidRI
002385OtherRIBLUE CHIP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
624AZMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Podiatric Physicians of Arizona, Inc. Foot & Ankle Surgery Past Accepting new patients
Podiatric Physicians of Arizona, Inc. Foot & Ankle Surgery Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437436800000",
    "number": "1154315174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4782 N 53RD ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850181955",
            "telephone_number": "602-750-1146",
            "fax_number": "888-232-6750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9188 E SAN SALVADOR DR",
            "address_2": "SUITE 201",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852585562",
            "telephone_number": "602-405-3247",
            "fax_number": "888-232-6750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERBER",
        "first_name": "BRUCE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-06",
        "last_updated": "2015-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "RI",
            "license": "DPM00200",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AZ",
            "license": "624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "961202",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "B/C & B/S OF RI",
            "identifier": "21286-7",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7005207",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "002385",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.