Individual provider Active NPI

Joanna Andujar, M.D.

  • Pediatrics Physician
  • Phoenix, AZ
National Provider Identifier
1245470293
Registry record updated Oct 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
47336 Issued in AZ
Practice address
2510 W Dunlap Ave
Ste 290
Phoenix, AZ 85021-2737
Phone
(602) 789-0344
Fax
(602) 789-8389
NPI assigned
Mar 4, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 47336 AZ Primary

Addresses

Primary practice location

2510 W Dunlap Ave
Ste 290
Phoenix, AZ 85021-2737

Mailing address

2510 W Dunlap Ave
Ste 290
Phoenix, AZ 85021-2737
Phone (602) 789-0344

Other identifiers 1

IdentifierTypeStateIssuer
838375MedicaidAZ

Other names 1

  • Dr. Joanna Andujar Professional name

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
I20161108000738 AZ Practitioner - Pediatric Medicine 0840579280 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Park Health Center Current Accepting new patients
Mountain Park Health Center CurrentSince Mar 27, 2017 Accepting new patients
Mountain Park Health Center CurrentSince Mar 27, 2017 Accepting new patients
Scottsdale Pediatrics and Pediatric Nephrology, PLLC Pediatrics PastSince Oct 27, 2024 Accepting new patients
Mountain Park Health Center - Dental Past Accepting new patients

Locations

2702 N 3rd St
Ste 4020
Phoenix, AZ 85004
Phone (602) 323-3345

6601 W Thomas Rd
Phoenix, AZ 85033

3003 N Central Ave
Ste 1600
Phoenix, AZ 85012
Phone (602) 323-3492

635 E Baseline Rd
Phoenix, AZ 85042

Organizations & group practices 5

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": "1236124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476144000000",
    "number": "1245470293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 W DUNLAP AVE",
            "address_2": "STE 290",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850212737",
            "telephone_number": "602-789-0344",
            "fax_number": "602-789-8389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 W DUNLAP AVE",
            "address_2": "STE 290",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850212737",
            "telephone_number": "602-789-0344",
            "fax_number": "602-789-8389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDUJAR",
        "first_name": "JOANNA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-04",
        "last_updated": "2016-10-11",
        "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": "47336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "838375",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOANNA",
            "last_name": "ANDUJAR",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.