Individual provider Active NPI

Dennis G Crandall, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Mesa, AZ
National Provider Identifier
1255399549
Registry record updated Nov 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
22422 Issued in AZ
Practice address
1432 S Dobson Rd
Suite 201
Mesa, AZ 85202-4768
Phone
(480) 962-0071
Fax
(480) 962-0590
NPI assigned
May 3, 2006
Last updated
Nov 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X 22422 AZ Primary

Addresses

Primary practice location

1432 S Dobson Rd
Suite 201
Mesa, AZ 85202-4768

Mailing address

1432 S Dobson Rd
Suite 201
Mesa, AZ 85202-4768
Phone (480) 962-0071

Other identifiers 1

IdentifierTypeStateIssuer
167800MedicaidAZ

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
I20040708000662 AZ Practitioner - Orthopedic Surgery 5597652008 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Saint Louis University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Honorhealth AmbulatoryGroup PAC ID 5991603110, 630 clinicians

Practice addresses (Care Compare)

10510 N 92ND St
Scottsdale, AZ 85258-4566

1255 W Rio Salado Pkwy
Suite 107
Tempe, AZ 85281-2892
Phone (480) 962-0071

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22422AZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sonoran Spine Center P.C. Orthopaedic Surgery of the Spine CurrentSince Jan 8, 2000 Accepting new patients
Honorhealth Ambulatory Current Accepting new patients
Honorhealth Ambulatory CurrentSince Mar 1, 2022 Accepting new patients
Honorhealth Ambulatory CurrentSince Mar 1, 2022 Accepting new patients
Honorhealth Ambulatory Orthopaedic Surgery Past Accepting new patients

Locations

3717 S Rome St
Gilbert, AZ 85297

5681 W Beverly Ln
Ste 101
Glendale, AZ 85306

1432 S Dobson Rd
Ste 201
Mesa, AZ 85202
Phone (480) 610-0925

2610 N 3rd St
Ste B
Phoenix, AZ 85004
Phone (602) 274-7600

33300 N 32nd Ave
Ste 101
Phoenix, AZ 85085
Phone (602) 443-4170

10510 N 92nd St
Ste 200
Scottsdale, AZ 85258
Phone (480) 323-1250

1255 W Rio Salado Pkwy
Ste 107
Tempe, AZ 85281
Phone (602) 443-4170

Interoperability endpoints

  • Direct secure messaging: dcrandall105428@direct.honorhealth.com
  • Direct secure messaging: denniscrandall@direct.summit-healthcare.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/ICIFBD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194566400000",
    "number": "1255399549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1432 S DOBSON RD",
            "address_2": "SUITE 201",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024768",
            "telephone_number": "480-962-0071",
            "fax_number": "480-962-0590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1432 S DOBSON RD",
            "address_2": "SUITE 201",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024768",
            "telephone_number": "480-962-0071",
            "fax_number": "480-962-0590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANDALL",
        "first_name": "DENNIS",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2007-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "AZ",
            "license": "22422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167800",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.