Individual provider Active NPI

Bunja Trawally

  • Physical Therapy Assistant
  • Scottsdale, AZ
National Provider Identifier
1245800267
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA-014181 Issued in AZ
Practice address
23005 N 74TH St
Scottsdale, AZ 85255-7500
Phone
(888) 842-3780
NPI assigned
Jun 30, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA-014181 AZ Primary

Addresses

Primary practice location

23005 N 74TH St
Scottsdale, AZ 85255-7500

Mailing address

16825 N 14TH St Unit 79
Phoenix, AZ 85022-7739
Phone (602) 770-9999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTA-014181AZMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1245800267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16825 N 14TH ST UNIT 79",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850227739",
            "telephone_number": "602-770-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23005 N 74TH ST",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852557500",
            "telephone_number": "888-842-3780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAWALLY",
        "first_name": "BUNJA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-30",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AZ",
            "license": "PTA-014181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.