Individual provider Active NPI

John J De Barros, MD

  • Surgery Physician
  • Mesa, AZ
National Provider Identifier
1194767228
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
33625 Issued in AZ
Practice address
4860 E Baseline Rd Ste 105
Mesa, AZ 85206-4670
Phone
(480) 485-8585
Fax
(480) 545-2673
NPI assigned
Jun 12, 2006
Last updated
May 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 33625 AZ Primary

Addresses

Primary practice location

4860 E Baseline Rd Ste 105
Mesa, AZ 85206-4670

Mailing address

PO Box 40640
Mesa, AZ 85274-0640
Phone (480) 485-8585

Other identifiers 1

IdentifierTypeStateIssuer
AZ0422490OtherAZBCBS AZ

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
I20050317000218 AZ Practitioner - General SurgeryPractitioner - Colorectal Surgery (Proctology)Practitioner - Other (Physician) 6709859333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Colorectal Surgery (Proctology)
Education
University of Connecticut School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prism Bariatrics LLCGroup PAC ID 7315319951, 2 clinicians

Practice addresses (Care Compare)

4860 E Baseline Rd
Suite 105
Mesa, AZ 85206-4670
Phone (480) 485-8585

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prism Bariatrics LLC Surgery CurrentSince Feb 1, 2023 Accepting new patients
Arizona Surgical Associates, PLC Surgery PastSince Sep 1, 2013 Accepting new patients
Pivot Weight Loss Center LLC PastSince Dec 26, 2021 Accepting new patients

Locations

4860 E Baseline Rd
Ste 105
Mesa, AZ 85206
Phone (480) 485-8585

9305 W Thomas Rd
Ste 180
Phoenix, AZ 85037
Phone (623) 362-2266

95 Soldiers Pass Rd
Ste B2
Sedona, AZ 86336
Phone (928) 862-2802

Organizations & group practices 8

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 1

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1194767228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40640",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852740640",
            "telephone_number": "480-485-8585",
            "fax_number": "480-545-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4860 E BASELINE RD STE 105",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064670",
            "telephone_number": "480-485-8585",
            "fax_number": "480-545-2673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE BARROS",
        "first_name": "JOHN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "33625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS AZ",
            "identifier": "AZ0422490",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.