David Laurtiz Jensen, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

005379 Issued in AZ

Practice address

3090 N Litchfield Rd Ste 120
Goodyear, AZ 85395-9214

Phone

(801) 874-3135

NPI assigned

Feb 2, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: david.jensen@541124689920004.direct.elationemr.com
• FHIR API: https://api.platform.athenahealth.com/20314/brand/1/csg/1/fhir/r4

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.

• Social Work Associates LLC

  • Family Medicine Physician
  • Scottsdale, AZ
  • NPI 1538573282
  Medicare reassignment NPD
• Synergy Physicians PLLC

  • Plastic and Reconstructive Surgery Physician
  • Scottsdale, AZ
  • NPI 1083271746

  Family Medicine

  NPD
• Pagnani Physical Therapy

  • Physical Therapist
  • Tooele, UT
  • NPI 1871976183
  NPD
• Arizona Family Care PLLC

  • Family Medicine Physician
  • Glendale, AZ
  • NPI 1952395444
  NPD (past)
• Banner Desert Sky Medical Clinic

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1194964825
  NPD (past)
• Banner Physician Specialists Arizona LLC

  • Multi-Specialty Clinic/Center
  • Page, AZ
  • NPI 1366799355
  NPD (past)
• Iora Health Massachusetts, P.C.

  • Internal Medicine Physician
  • Hyannis, MA
  • NPI 1851858666
  NPD (past)
• Iora Health, LLC

  • Internal Medicine Physician
  • Hanover, NH
  • NPI 1700285616
  NPD (past)

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

{
    "created_epoch": "1265068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574640000000",
    "number": "1174855159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3090 N LITCHFIELD RD STE 120",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853959214",
            "telephone_number": "801-874-3135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3090 N LITCHFIELD RD STE 120",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853959214",
            "telephone_number": "801-874-3135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "DAVID",
        "middle_name": "LAURTIZ",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-02",
        "last_updated": "2019-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "9167838-8904",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "005379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1174855159",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "569756",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Java Autism Services LLC
• Jay S. Suaverdez DDS PLLC
• Jca Afc Homes
• Penny M Jefferson, RN
• Patrick Jennings, PT, DPT
• Samuel Jensen
• Jerome a Cohn DPM PC
• Jerome a Cohn, DPM, PC
• Kyle Jervis, PA-C
• Kaitlin Suzanne Jeter, LAMFT

• Family Medicine Physician in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.