Individual provider Active NPI

Jeffrey Barton Alpern, DO

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Glendale, AZ
National Provider Identifier
1174524789
Registry record updated Dec 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
3749 Issued in AZ
Practice address
21579 N 56TH Ave
Suite 117
Glendale, AZ 85308-6287
Phone
(610) 737-4445
Fax
(623) 428-0069
NPI assigned
Aug 4, 2005
Last updated
Dec 4, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 3749 AZ Primary

Addresses

Primary practice location

21579 N 56TH Ave
Suite 117
Glendale, AZ 85308-6287

Mailing address

21579 N 56TH Ave
Glendale, AZ 85308-6287
Phone (610) 737-4445

Other identifiers 3

IdentifierTypeStateIssuer
0010425420010MedicaidPA
P00244441OtherAZRAILROAD MEDICARE
825961MedicaidAZ

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
I20040621001550 AZ Practitioner - Vascular SurgeryPractitioner - Thoracic SurgeryPractitioner - Cardiac Surgery 3173508447 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Vein Restoration Az LLC CurrentSince Nov 1, 2019 Accepting new patients
Center for Vein Restoration Az LLC Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Nov 1, 2019 Accepting new patients
Ahi Cardiovascular Surgeons LTD Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients
Desert Cardiovascular Surgeons LLC Thoracic Surgery (Cardiothoracic Vascular Surgery) PastSince Apr 8, 2009 Accepting new patients
Cardiopulmonary Surgical Associates, PLC Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients

Locations

3509 S Mercy Rd
Ste 101
Gilbert, AZ 85297

9515 W Camelback Rd
Ste 108
Phoenix, AZ 85037
Phone (602) 428-0068

Interoperability endpoints

  • Direct secure messaging: jeffrey.alperndo.p3@direct.cvr.nextgenshare.com

Organizations & group practices 6

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": "1123113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417651200000",
    "number": "1174524789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21579 N 56TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086287",
            "telephone_number": "610-737-4445",
            "fax_number": "623-428-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21579 N 56TH AVE",
            "address_2": "SUITE 117",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086287",
            "telephone_number": "610-737-4445",
            "fax_number": "623-428-0069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALPERN",
        "first_name": "JEFFREY",
        "middle_name": "BARTON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-04",
        "last_updated": "2014-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "AZ",
            "license": "3749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010425420010",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00244441",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "825961",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.