David John Bennett, D.O
Individual provider Active NPI Family Medicine Physician · Sun City West, AZ
NPI 1154375426 · NPPES record last updated Feb 1, 2008
Key facts
- NPI
- 1154375426
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 3809 (AZ)
- Practice address
- 14502 West Meeker Boulevard
Sun City West, AZ 85375 - Phone
- (623) 214-4000
- NPI assigned
- May 20, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 12
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- West Virginia School of Osteopathic Medicine, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Tec Emergency Physicians of Arizona, LLC
Practice addresses (Care Compare)
251 N Estrella Pkwy
Goodyear, AZ 85338-9334
Phone (888) 732-3317
Hospital & facility affiliations
- Dignity Health - Arizona General Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040426001170 | AZ | Practitioner - Emergency Medicine | 9032106877 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3809 | AZ | MD | Clinical Psychologist |
| 1957 | AZ | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Quantum Healthcare Medical Associates of Arizona, PC | Emergency Medicine | Current |
Accepting new patients |
| Emergency Physicians Southwest, PC | Emergency Medicine | Current |
Accepting new patients |
| Tec Emergency Physicians of Arizona, LLC | Current |
Accepting new patients | |
| Cep America - Arizona PC | Emergency Medicine | Current |
Accepting new patients |
| Cep America-Arizona, PC | Emergency Medicine | Current |
Accepting new patients |
| Cep America- Arizona, PC | Emergency Medicine | Current | Accepting new patients |
| Team Physicians of Arizona PC | Emergency Medicine | Past | Accepting new patients |
| Fayette Community Hospital, Inc. | Past | Accepting new patients |
Locations
1900 N Higley Rd
Gilbert, AZ 85234
Phone (480) 543-2000
251 N Estrella Pkwy
Goodyear, AZ 85338
Phone (623) 322-6900
6644 E Baywood Ave
Mesa, AZ 85206
Phone (480) 321-2000
1419 W Hunt Hwy
San Tan Vly, AZ 85143
Phone (480) 245-4300
10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690
14502 W Meeker Blvd
Sun City West, AZ 85375
Phone (623) 214-4000
5125 S Rural Rd
Tempe, AZ 85282
Phone (480) 306-8780
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 3809 | AZ | Yes |
Addresses
Primary practice location
14502 West Meeker Boulevard
Sun City West, AZ 85375
Mailing address
2100 Powell Street
Ste. 920
Emeryville, CA 94608-1803
Phone (510) 350-2600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 714099 | Medicaid | AZ |
NPI Registry JSON
{
"created_epoch": "1148083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201824000000",
"number": "1154375426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 POWELL STREET",
"address_2": "STE. 920",
"city": "EMERYVILLE",
"state": "CA",
"postal_code": "946081803",
"telephone_number": "510-350-2600",
"fax_number": "510-879-9100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14502 WEST MEEKER BOULEVARD",
"city": "SUN CITY WEST",
"state": "AZ",
"postal_code": "85375",
"telephone_number": "623-214-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "DAVID",
"middle_name": "JOHN",
"credential": "D.O",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-20",
"last_updated": "2008-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AZ",
"license": "3809",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "714099",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sun City West, AZ
- Beech Home Care & Medical, Inc.
- Angela Paula Ortigas Beltran
- John Michael Benavidez
- Sarah Benberou
- Tanner Jacob Benedict
- Mark A Benson
- Christina Bentley
- Stephanie Benton
- Andrew Alan Berlowitz
- Katharine M Bermingham Cordova
All providers in Sun City West, AZ · Family Medicine Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 1, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.