NPIMap

Individual provider Active NPI

Mary Jean Fietz, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Tempe, AZ
National Provider Identifier
1154396133
Registry record updated Mar 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
20108 Issued in AZ
Practice address
1255 W Washington St
Tempe, AZ 85281-1210
Phone
(602) 685-5211
Fax
(602) 685-5028
NPI assigned
Feb 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 20108 AZ Primary

Addresses

Primary practice location

1255 W Washington St
Tempe, AZ 85281-1210

Mailing address

1255 W Washington St
Tempe, AZ 85281-1210
Phone (602) 685-5211

Other identifiers 5

IdentifierTypeStateIssuer
AZ0182900OtherAZBCBSAZ-PATH ASSOC
AZ0828930OtherAZBCBSAZ-SUN CITY PATH
AX4478OtherAZHEALTH NET AZ-PATH ASSOC
111287MedicaidAZ
1Z7112OtherAZHEALTH NET AZ-SUN CITY PA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090501000184 AZ Practitioner - Pathology 7618990532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Oklahoma College of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs PathologyGroup PAC ID 5496730590, 12 clinicians

Practice addresses (Care Compare)

350 W Thomas Rd
Phoenix, AZ 85013-4409
Phone (602) 406-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.64 of 100Reported as group
Quality
85
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Pathology Clinical Pathology CurrentSince Jan 15, 2010 Accepting new patients
Sjhmc Physician Services Current Accepting new patients
Sun Health MRI Center Past Accepting new patients

Locations

350 W Thomas Rd
Phoenix, AZ 85013
Phone (480) 339-5001

500 W Thomas Rd
Ste 400
Phoenix, AZ 85013
Phone (602) 406-3874

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

File 56765
Los Angeles, CA 90074

Organizations & group practices 3

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490054400000",
    "number": "1154396133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 W WASHINGTON ST",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852811210",
            "telephone_number": "602-685-5211",
            "fax_number": "602-685-5325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 W WASHINGTON ST",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852811210",
            "telephone_number": "602-685-5211",
            "fax_number": "602-685-5028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIETZ",
        "first_name": "MARY",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-22",
        "last_updated": "2017-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AZ",
            "license": "20108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSAZ-PATH ASSOC",
            "identifier": "AZ0182900",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSAZ-SUN CITY PATH",
            "identifier": "AZ0828930",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET AZ-PATH ASSOC",
            "identifier": "AX4478",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111287",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET AZ-SUN CITY PA",
            "identifier": "1Z7112",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

Verify at the official NPI Registry.