Jeffrey Richard Holzberg, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

54607 Issued in AZ

Practice address

815 E 15TH St
Douglas, AZ 85607-1631

Phone

(520) 364-5437

Fax

(520) 364-4261

NPI assigned

Mar 28, 2014

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jeffrey.holzberg.p1@direct.cchci.nextgenshare.com

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.

• Chiricahua Community Health Centers, Inc

  dba Business Office

  • Federally Qualified Health Center (FQHC)
  • Douglas, AZ
  • NPI 1942241443
  Medicare reassignment NPD
• Chiricahua Community Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Elfrida, AZ
  • NPI 1457489890
  NPD
• Chiricahua Community Health Centers, Inc.

  dba Willcox Clinic

  • Federally Qualified Health Center (FQHC)
  • Willcox, AZ
  • NPI 1285488866
  NPD

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

{
    "created_epoch": "1395964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1235556168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 F AVE",
            "city": "DOUGLAS",
            "state": "AZ",
            "postal_code": "856071920",
            "telephone_number": "520-364-6852",
            "fax_number": "520-364-4261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 E 15TH ST",
            "city": "DOUGLAS",
            "state": "AZ",
            "postal_code": "856071631",
            "telephone_number": "520-364-5437",
            "fax_number": "520-364-4261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13001 E 17th Pl",
            "address_2": "University of Colorado School of Medicine GME",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800452570",
            "country_code": "US",
            "telephone_number": "720-777-3846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLZBERG",
        "first_name": "JEFFREY",
        "middle_name": "RICHARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "54607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jill M. Hamilton, N.P.
• Haven of Douglas, LLC
• Helping Ourselves Pursue Enrichment, Inc. (HOPE, Inc)
• Debra Hill, M.S. CCC-SLP
• Holistic Healing and Wellness Center, P.C.
• Anahi Huang Hsu, M.D.
• Priscilla Hudson Enriquez, RN
• Infinia at Douglas
• Ximena Rodriguez Iniguez
• Lamar Richard Innes, ATC

• Pediatrics Physician in Douglas, AZ
• Providers in Douglas, AZ by specialty
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.