Individual provider Active NPI

Pawarid Techathaveewat, D.O.

  • Endocrinology, Diabetes & Metabolism Physician
  • Glendale, AZ
National Provider Identifier
1184088809
Registry record updated Jan 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
008536 Issued in AZ
Practice address
7701 W Aspera Blvd
Glendale, AZ 85308-7947
Phone
(623) 248-2108
NPI assigned
Apr 8, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 008536 AZ
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 008536 AZ Primary

Addresses

Primary practice location

7701 W Aspera Blvd
Glendale, AZ 85308-7947

Mailing address

7701 W Aspera Blvd
Glendale, AZ 85308-7947
Phone (623) 248-2108

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
I20210629002363 AZ Practitioner - Endocrinology 7315348265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Banner Physician Specialists Arizona LLCGroup PAC ID 6204002272, 371 clinicians

Practice addresses (Care Compare)

10401 W Thunderbird Blvd
Sun City, AZ 85351-3004
Phone (623) 832-4000

7701 W Aspera Blvd
Stes 102 201 301
Glendale, AZ 85308-7935
Phone (623) 248-2100

9165 W Thunderbird Rd
Suite 200
Peoria, AZ 85381-4847
Phone (623) 285-1120

Hospital & facility affiliations

  • Banner Thunderbird Medical Center Hospital, Glendale, AZ, CCN 030089
  • Banner - University Medical Center Phoenix Hospital, Phoenix, AZ, CCN 030002

Merit-based Incentive Payment System (MIPS)

Final score
84.12 of 100Reported as group
Quality
76.35
Promoting interoperability
99
Improvement activities
40
Cost
71.55

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
008536AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Physician Specialists Arizona LLC CurrentSince Jul 1, 2021 Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Jan 26, 2022 Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Jul 1, 2021 Accepting new patients
Banner Primary Care Physicians Arizona LLC PastSince Jan 26, 2022 Accepting new patients

Locations

7701 W Aspera Blvd
#1
Glendale, AZ 85308

7701 W Aspera Blvd
Ste 102
Glendale, AZ 85308
Phone (623) 248-2100

7701 W Aspera Blvd
Glendale, AZ 85308
Phone (623) 248-2100

9165 W Thunderbird Rd
Ste 10220
Peoria, AZ 85381

9165 W Thunderbird Rd
Ste 100
Peoria, AZ 85381
Phone (623) 523-6560

9165 W Thunderbird Rd
Peoria, AZ 85381
Phone (623) 285-1120

9165 W Thunderbird Rd
Ste 200
Peoria, AZ 85381
Phone (623) 285-1120

1111 E McDowell Rd
#2
Phoenix, AZ 85006
Phone (602) 839-2296

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

Organizations & group practices 4

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 2

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": "1460073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642204800000",
    "number": "1184088809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7701 W ASPERA BLVD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853087947",
            "telephone_number": "623-248-2108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7701 W ASPERA BLVD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853087947",
            "telephone_number": "623-248-2108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TECHATHAVEEWAT",
        "first_name": "PAWARID",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-08",
        "last_updated": "2022-01-15",
        "certification_date": "2022-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "008536",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "AZ",
            "license": "008536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.