Individual provider Active NPI

Arseny Bezprozvanny, M.D.

  • Emergency Medicine Physician
  • Chandler, AZ
National Provider Identifier
1215375530
Registry record updated Apr 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
255439 Issued in MA
Practice address
1955 W Frye Rd
Chandler, AZ 85224-6282
Phone
(480) 728-3753
NPI assigned
Jun 8, 2013
Last updated
Apr 14, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 255439 MA Primary

Addresses

Primary practice location

1955 W Frye Rd
Chandler, AZ 85224-6282

Mailing address

1 Deaconess Rd
2ND Floor - Deparment Emergency Medicine
Boston, MA 02215-5321
Phone (617) 667-7000

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
I20160715001736 AZ Practitioner - Emergency Medicine 1850683582 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Baylor College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chandler Emergency Medical Group LLCGroup PAC ID 1658272968, 47 clinicians

Practice addresses (Care Compare)

1955 W Frye Rd
Chandler, AZ 85224-6282
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
255439MAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chandler Emergency Medical Group, LLC Emergency Medicine CurrentSince Jul 1, 2016 Accepting new patients
Critical Care Consultants LLC Current Accepting new patients

Locations

1955 W Frye Rd
Chandler, AZ 85224
Phone (480) 507-2961

3555 S Val Vista Dr
Gilbert, AZ 85297
Phone (480) 434-4356

Organizations & group practices 2

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 2

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": "1370649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1215375530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DEACONESS RD",
            "address_2": "2ND FLOOR - DEPARMENT EMERGENCY MEDICINE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155321",
            "telephone_number": "617-667-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 W FRYE RD",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852246282",
            "telephone_number": "480-728-3753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEZPROZVANNY",
        "first_name": "ARSENY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-08",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "255439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.