Ayman Shabib Alhadheri, MD
Individual provider Active NPI Emergency Medicine Physician · Mesa, AZ
NPI 1184205403 · NPPES record last updated Jul 1, 2024
Key facts
- NPI
- 1184205403
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 4301510071 (MI)
- Practice address
- 6644 E Baywood Ave
Mesa, AZ 85206-1747 - Phone
- (480) 321-2000
- NPI assigned
- Apr 19, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Emergency Physicians Southwest PC
Practice addresses (Care Compare)
1800 E Florence Blvd
Casa Grande, AZ 85122-5303
Phone (520) 381-6300
Hospital & facility affiliations
- Banner Baywood Medical Center
- Banner Casa Grande Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MI, AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231005000959 | MI | Practitioner - Emergency Medicine | 1557731908 | Reassigns benefits to 1 organization |
| I20240828001140 | AZ | Practitioner - Emergency Medicine | 1557731908 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301510071 | MI | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Physicians Southwest, PC | Emergency Medicine | Current |
Accepting new patients |
| Quantum Healthcare Medical Associates of Arizona, PC | Emergency Medicine | Current |
Accepting new patients |
Locations
1800 E Florence Blvd
Casa Grande, AZ 85122
Phone (520) 381-6285
6644 E Baywood Ave
Mesa, AZ 85206
Phone (480) 321-2000
807 S Ponderosa St
Payson, AZ 85541
Phone (520) 474-3222
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 4301510071 | MI | Yes |
Addresses
Primary practice location
6644 E Baywood Ave
Mesa, AZ 85206-1747
Mailing address
6644 E Baywood Ave
Mesa, AZ 85206-1747
Phone (480) 321-2000
Other providers in Mesa, AZ
- Alfonso a Tan MD PC
- Yanelys Alfonso
- James Abraham Alford II
- Eric Christian Alfrey
- Stephen Alger
- Mouhsen H Alhakeem
- Manal Alhakim
- Suhail Alhreish
- Arefeh Ali Cheshmeh Alaei
- Ali H. Nia, D.M.D., P.C.
All providers in Mesa, AZ · Emergency Medicine Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.