Individual provider Active NPI

Bruce D. Noland, M.D.

  • Gastroenterology Physician
  • Phoenix, AZ
National Provider Identifier
1245280346
Registry record updated Feb 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
22429 Issued in AZ
Practice address
349 E Coronado Rd
Phoenix, AZ 85004-1525
Phone
(602) 266-5678
Fax
(602) 264-5646
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 22429 AZ Primary

Addresses

Primary practice location

349 E Coronado Rd
Phoenix, AZ 85004-1525

Mailing address

3020 E Camelback Rd
Suite 301
Phoenix, AZ 85016-5095
Phone (602) 264-9100

Other identifiers 3

IdentifierTypeStateIssuer
176017-05MedicaidAZ
317047OtherAZGROUP MEDICAID NUMBER
120390OtherAZGROUP MEDICARE NUMBER

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
I20040504000977 AZ Practitioner - Gastroenterology 8921096397 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22429AZMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Digestive Health, PC Gastroenterology CurrentSince May 1, 2008 Accepting new patients
Michael S. Altman, M.D., P.L.C. Gastroenterology Past Accepting new patients

Locations

5823 W Eugie Ave
Ste A
Glendale, AZ 85304
Phone (602) 439-1717

3020 E Camelback Rd
Ste 301
Phoenix, AZ 85016

349 E Coronado Rd
Phoenix, AZ 85004
Phone (602) 266-5678

9305 W Thomas Rd
Ste 370
Phoenix, AZ 85037
Phone (623) 298-5220

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487289600000",
    "number": "1245280346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 E CAMELBACK RD",
            "address_2": "SUITE 301",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165095",
            "telephone_number": "602-264-9100",
            "fax_number": "602-264-9101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "349 E CORONADO RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041525",
            "telephone_number": "602-266-5678",
            "fax_number": "602-264-5646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLAND",
        "first_name": "BRUCE",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2017-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AZ",
            "license": "22429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176017-05",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID NUMBER",
            "identifier": "317047",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE NUMBER",
            "identifier": "120390",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.