Active NPI
Jonathan L Dameworth, M.D.
- Colon & Rectal Surgery Physician
- Phoenix, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Colon & Rectal Surgery Physician
- License
- 64001
- Practice address
- 500 W Thomas Rd Ste 400
Phoenix, AZ 85013-4238 - Phone
- (602) 406-3874
- Fax
- (602) 406-2335
- NPI assigned
- May 2, 2015
- Last updated
- Nov 6, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Colon & Rectal Surgery Physician | 208C00000X | 64001 | AZ | Primary |
Addresses
Primary practice location
500 W Thomas Rd Ste 400
Phoenix, AZ 85013-4238
Mailing address
PO Box 33269
Phoenix, AZ 85067-3269
Phone (602) 406-4786
Other practice location 1
625 N 6th St
Phoenix, AZ 85004-2155
Phone (602) 406-8222
Other practice location 2
10214 N Tatum Blvd Ste A600
Phoenix, AZ 85028-4247
Phone (602) 406-1530
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ, WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Colorectal Surgery (Proctology)
- Education
- Creighton University School of Medicine, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1100 9TH Ave
Seattle, WA 98101-2756
Phone (206) 223-6600
500 W Thomas Rd
400 DHMG St. Joseph's Surgical Specialty
Phoenix, AZ 85013-4238
Phone (602) 406-3874
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 31 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64001 | AZ | MD | Colon & Rectal Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Joseph's Hospital and Medical Center | Current | Accepting new patients | |
| St Josephs Pathology | Current | Accepting new patients | |
| Sjhmc Physician Services | Current | Accepting new patients | |
| Dignity Health | Past | Accepting new patients | |
| Dignity Health | Past | Accepting new patients |
Locations
7330 N 99th Ave
Ste 200A
Glendale, AZ 85307
Phone (602) 406-3400
10214 N Tatum Blvd
Ste A600
Phoenix, AZ 85028
Phone (602) 406-1530
350 W Thomas Rd
Phoenix, AZ 85013
Phone (480) 339-5001
500 W Thomas Rd
Ste 400
Phoenix, AZ 85013
Phone (602) 406-3874
500 W Thomas Rd
Ste 680
Phoenix, AZ 85013
Phone (602) 406-6017
625 N 6th St
Phoenix, AZ 85004
Phone (602) 406-8222
625 N 6th St
Ste 402
Phoenix, AZ 85004
Phone (602) 406-8222
File 56765
Los Angeles, CA 90074
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.
-
dba St. Joseph's Faculty Physicians
- Multi-Specialty Clinic/Center
- Phoenix, AZ
- NPI 1326098005
-
- General Acute Care Hospital
- Seattle, WA
- NPI 1801851258
-
dba SJHMC Trauma Services
- Emergency Care Clinic/Center
- Phoenix, AZ
- NPI 1255382412
-
dba Pathology Associates LTD
- Anatomic Pathology & Clinical Pathology Physician
- Phoenix, AZ
- NPI 1265407738
-
dba St. Joseph's Hospital and Medical Center
- General Acute Care Hospital
- Phoenix, AZ
- NPI 1982733655
-
dba Mercy Medical Center Redding
- General Acute Care Hospital
- Redding, CA
- NPI 1477671535
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba St. Josephs Hospital and Medical Center Emergency Dept-Litchfield Park
- Emergency Care Clinic/Center
- Litchfield Park, AZ
- NPI 1265065445
Hospital
-
dba St. Josephs Hospital and Medical Center Emergency Dept-Glendale
- Emergency Care Clinic/Center
- Glendale, AZ
- NPI 1609408665
Hospital
-
dba St. Joseph's Hospital and Medical Center
- General Acute Care Hospital
- Phoenix, AZ
- NPI 1982733655
-
dba St. Joseph's Westgate Medical Center
- General Acute Care Hospital
- Glendale, AZ
- NPI 1992131734
-
- General Acute Care Hospital
- Seattle, WA
- NPI 1801851258
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730851200000",
"number": "1194102772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 33269",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850673269",
"telephone_number": "602-406-4786",
"fax_number": "916-636-4358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 W THOMAS RD STE 400",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850134238",
"telephone_number": "602-406-3874",
"fax_number": "602-406-2335"
}
],
"practiceLocations": [
{
"address_1": "625 N 6th St",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850042155",
"country_code": "US",
"telephone_number": "602-406-8222",
"fax_number": "602-406-7811",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "10214 N Tatum Blvd Ste A600",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850284247",
"country_code": "US",
"telephone_number": "602-406-1530",
"fax_number": "602-406-1539",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAMEWORTH",
"first_name": "JONATHAN",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-05-02",
"last_updated": "2024-11-06",
"certification_date": "2024-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "208C00000X",
"taxonomy_group": "",
"desc": "Colon & Rectal Surgery",
"state": "AZ",
"license": "64001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.