Individual provider Active NPI

Nezar N Dahdal, MD

  • Internal Medicine Physician
  • Glendale, AZ
National Provider Identifier
1194977405
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
46720 Issued in AZ
Practice address
5421 W Thunderbird Rd
Glendale, AZ 85306-4751
Phone
(480) 690-7779
NPI assigned
Oct 17, 2008
Last updated
Jan 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 250348 NY
Internal Medicine Physician 207R00000X 46720 AZ Primary
Hospitalist Physician 208M00000X 46720 AZ

Addresses

Primary practice location

5421 W Thunderbird Rd
Glendale, AZ 85306-4751

Mailing address

24002 Via Fabricante Ste 201
Mission Viejo, CA 92691-3931
Phone (623) 200-3746

Other practice location 1

24002 Via Fabricante Ste 201
Mission Viejo, CA 92691-3931
Phone (949) 416-0950

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
I20130121000063 AZ Practitioner - HospitalistPractitioner - Internal Medicine 7214093236 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summit Medical Group Arizona LLCGroup PAC ID 3173872835, 152 clinicians

Practice addresses (Care Compare)

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

19829 N 27TH Ave
Phoenix, AZ 85027-4001
Phone (623) 879-6100

5620 W Thunderbird Rd
Suite F1
Glendale, AZ 85306-4652
Phone (888) 698-6727

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
250348NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group Arizona LLC Internal Medicine CurrentSince Apr 25, 2022 Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Jan 1, 2022 Accepting new patients
Banner Hospital Based Physicians Arizona LLC Current Accepting new patients
Vituity - Arizona Hospitalists PC Internal Medicine Current Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Jan 1, 2022 Accepting new patients
Vituity - Arizona Hospitalists PC Hospitalist CurrentSince Apr 1, 2023 Accepting new patients
Allen Family Medicine PLLC Past Accepting new patients
Phoenician Hospice LLC PastSince Aug 17, 2015 Accepting new patients

Locations

5421 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 547-9615

5555 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 588-5555

5620 W Thunderbird Rd
Ste F1
Glendale, AZ 85306
Phone (602) 938-6960

14541 W Indian School Rd
#600
Goodyear, AZ 85395
Phone (623) 535-5599

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

19829 N 27th Ave
Phoenix, AZ 85027
Phone (602) 879-5720

33400 N 32nd Ave
Phoenix, AZ 85085
Phone (540) 998-0000

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

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19654/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/21654/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/22064/brand/1/csg/1/fhir/r4
  • Direct secure messaging: nezar.dahdal.1@19654.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Billet HealthGlendale, AZ, CCN 031777 Hospice 5% Or Greater Direct Ownership Interest (25%)
W-2 Managing Employee (25%)
Oct 1, 2022
Oct 1, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 4

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": "1224201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1194977405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24002 VIA FABRICANTE STE 201",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926913931",
            "telephone_number": "623-200-3746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5421 W THUNDERBIRD RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064751",
            "telephone_number": "480-690-7779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24002 Via Fabricante Ste 201",
            "address_purpose": "LOCATION",
            "city": "Mission Viejo",
            "state": "CA",
            "postal_code": "926913931",
            "country_code": "US",
            "telephone_number": "949-416-0950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAHDAL",
        "first_name": "NEZAR",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-17",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "250348",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "46720",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AZ",
            "license": "46720",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.