NPIMap

Individual provider Active NPI

Bruce A. Takahashi, DO

  • Internal Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1164463907
Registry record updated Jun 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
3133 Issued in AZ
Practice address
934 W Hatcher Rd
Phoenix, AZ 85021-3139
Phone
(602) 344-6300
Fax
(602) 344-6301
NPI assigned
Jun 10, 2006
Last updated
Jun 27, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 3133 AZ Primary

Addresses

Primary practice location

934 W Hatcher Rd
Phoenix, AZ 85021-3139

Mailing address

2929 E Thomas Rd
Phoenix, AZ 85016-8034
Phone (602) 470-5000

Other identifiers 1

IdentifierTypeStateIssuer
349739MedicaidAZ

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
I20050803000489 AZ Practitioner - Internal MedicinePractitioner - Geriatric Medicine 4981632585 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
District Medical Group IncGroup PAC ID 7315086691, 454 clinicians

Practice addresses (Care Compare)

2601 E Roosevelt St
Phoenix, AZ 85008-4973
Phone (602) 344-5011

3141 N 3Rd Ave
Phoenix, AZ 85013-4360
Phone (602) 914-1520

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3133AZMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc Family Medicine CurrentSince Jan 1, 2010 Accepting new patients
District Medical Group, Inc Current Accepting new patients

Locations

950 E Van Buren St
Avondale, AZ 85323
Phone (623) 344-6800

811 S Hamilton St
Chandler, AZ 85225
Phone (480) 344-6100

2525 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 344-1015

2525 E Roosevelt St
Fl 2
Phoenix, AZ 85008

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

3141 N 3rd Ave
Ste 100
Phoenix, AZ 85013
Phone (602) 914-1520

33 W Tamarisk St
Phoenix, AZ 85041
Phone (602) 344-6400

934 W Hatcher Rd
Phoenix, AZ 85021
Phone (602) 344-6300

Interoperability endpoints

  • Direct secure messaging: btakahashi4983@direct.valleywisehealth.org

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.

Hospital & facility affiliations 12

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": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340755200000",
    "number": "1164463907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850168034",
            "telephone_number": "602-470-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "934 W HATCHER RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850213139",
            "telephone_number": "602-344-6300",
            "fax_number": "602-344-6301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKAHASHI",
        "first_name": "BRUCE",
        "middle_name": "A.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2012-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "3133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "349739",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.