NPIMap

Individual provider Active NPI

Judy Marie Pinsonneault, D.O.

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1184627648
Registry record updated May 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2762 Issued in AZ
Practice address
4212 N 16TH St
Phoenix, AZ 85016-5319
Phone
(602) 263-1501
Fax
(602) 263-1547
NPI assigned
May 27, 2005
Last updated
May 3, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2762 AZ Primary
Family Medicine Physician 207Q00000X DO27753 OR

Addresses

Primary practice location

4212 N 16TH St
Phoenix, AZ 85016-5319

Mailing address

PO Box 31001-0698
Pasadena, CA 91110-0698
Phone (602) 263-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20031212000563 AZ Practitioner - Family Practice 6204733892
I20161119000015 TX Practitioner - Family Practice 6204733892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of LincolnGroup PAC ID 3375439862, shared by 5 NPIs, 28 clinicians

Practice addresses (Care Compare)

1105 SE Jetty Ave
Lincoln City, OR 97367-2604
Phone (541) 265-4947

36 SW Nye St
Newport, OR 97365-3821
Phone (541) 265-4947

36 Swnye St
Newport, OR 97365-3821

525 N Bay St
Waldport, OR 97394-9010
Phone (541) 265-4947

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2762AZMDGeneral Practice Dentistry
DO27753ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cigna Healthcare of Arizona, Inc. CurrentSince Oct 9, 2017 Accepting new patients
Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm CurrentSince Oct 30, 2016 Accepting new patients
Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm CurrentSince Oct 30, 2016 Accepting new patients
Cigna Health Care of Arizona Inc. CurrentSince Oct 9, 2017 Accepting new patients
Judy M Pinsonneault, D.O., P.C. PastSince Aug 13, 1993 Accepting new patients

Locations

2121 W Reservation Loop Rd
Camp Verde, AZ 86322
Phone (929) 567-2168

3805 E Bell Rd
Ste 2100
Phoenix, AZ 85032
Phone (602) 404-5200

4212 N 16th St
Phoenix, AZ 85016
Phone (602) 248-4187

8888 E Raintree Dr
Fl 3
Scottsdale, AZ 85260

Organizations & group practices 5

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.

Hospital & facility affiliations 21

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556841600000",
    "number": "1184627648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31001-0698",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911100698",
            "telephone_number": "602-263-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4212 N 16TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165319",
            "telephone_number": "602-263-1501",
            "fax_number": "602-263-1547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINSONNEAULT",
        "first_name": "JUDY",
        "middle_name": "MARIE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-27",
        "last_updated": "2019-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "2762",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO27753",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.