Individual provider Active NPI

Michelle B Huddleston, MD

  • Pediatrics Physician
  • Phoenix, AZ
National Provider Identifier
1164484200
Registry record updated Jan 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25759 Issued in AZ
Practice address
1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone
(602) 933-0945
Fax
(602) 933-0222
NPI assigned
Apr 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25759 AZ Primary

Addresses

Primary practice location

1919 E Thomas Rd
Phoenix, AZ 85016-7710

Mailing address

1919 E Thomas Rd
BLDG 2108, Ste 101
Phoenix, AZ 85016-7710
Phone (602) 512-8029

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
I20060112000335 AZ Practitioner - Internal MedicinePractitioner - Pediatric Medicine 8123041456 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Brody School of Medicine at East Carolina University, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1111 E McDowell Rd
Phoenix, AZ 85006-2612
Phone (602) 839-2000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner - University Hospital Based Physicians LLC CurrentSince Jan 1, 2016 Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince May 1, 2014 Accepting new patients
Phoenix Children'S Hospital Pediatrics Current Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince May 1, 2014 Accepting new patients
Banner - University Hospital Based Physicians LLC CurrentSince Jan 1, 2016 Accepting new patients
Banner Hospital Based Physicians Arizona LLC Current Accepting new patients
Phoenix Children'S Hospital Hope Past Accepting new patients
Banner - University Medical Center Phoenix Past Accepting new patients

Locations

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

925 E McDowell Rd
Fl 3
Phoenix, AZ 85006
Phone (602) 839-5895

1919 E Thomas Rd
Bldg 2108
Phoenix, AZ 85016
Phone (602) 512-8030

1648 S 16th St
Phoenix, AZ 85034
Phone (602) 448-0935

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

3333 E Van Buren St
Phoenix, AZ 85008
Phone (602) 690-0598

1300 N 12th St
Ste 508
Phoenix, AZ 85006
Phone (602) 839-3927

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358380800000",
    "number": "1164484200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "address_2": "BLDG 2108, STE 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-512-8029",
            "fax_number": "602-512-8161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-933-0945",
            "fax_number": "602-933-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDDLESTON",
        "first_name": "MICHELLE",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-04",
        "last_updated": "2013-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "25759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.