Active NPI
Joanna Andujar, M.D.
- Pediatrics Physician
- Phoenix, AZ
National Provider Identifier
1245470293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 47336
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 838375 | Medicaid | AZ |
Other names 1
- Dr. Joanna Andujar
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mountain Park Health Center | Current | Accepting new patients | |
| Mountain Park Health Center | Current | Accepting new patients | |
| Mountain Park Health Center | Current | Accepting new patients | |
| Scottsdale Pediatrics and Pediatric Nephrology, PLLC | Pediatrics | Past | 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.
-
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1386452415
-
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1669878567
-
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1710146188
-
- Pediatrics Physician
- Phoenix, AZ
- NPI 1629076518
Pediatrics
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2016; 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.