Individual provider Active NPI

Edward Tognacci, DO

  • General Practice Physician
  • Phoenix, AZ
National Provider Identifier
1265410351
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
5101015106 Issued in MI
Practice address
1111 E McDowell Rd
Phoenix, AZ 85006-2612
Phone
(602) 839-6968
Fax
(602) 839-4144
NPI assigned
Jan 9, 2006
Last updated
Jul 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 5101015106 MI
General Practice Physician 208D00000X 5101015106 MI Primary

Addresses

Primary practice location

1111 E McDowell Rd
Phoenix, AZ 85006-2612

Mailing address

PO Box 15070
Scottsdale, AZ 85267-5070
Phone (602) 839-6968

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070109000376 AZ Practitioner - Emergency Medicine 3173569746 Reassigns benefits to 2 organizations
I20090721000687 TX Practitioner - Emergency Medicine 3173569746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1110 E Route 66
Suite 100
Flagstaff, AZ 86001-4772
Phone (928) 773-9695

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4484AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Winslow Indian Health Care Center, Inc CurrentSince Dec 13, 2009 Accepting new patients
North Valley Emergency Specialists CurrentSince Sep 1, 2016 Accepting new patients
Winslow Indian Health Care Center, Inc CurrentSince Dec 13, 2009 Accepting new patients
American Current Care of Arizona PA CurrentSince Jun 27, 2022 Accepting new patients
Flagstaff Emergency Physicians Past Accepting new patients
Professional Pathology Associates, PC Past Accepting new patients
Willard Emergency Physicians Past Accepting new patients

Locations

1110 E Route 66
Ste 100
Flagstaff, AZ 86001
Phone (928) 527-1920

5555 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 588-5555

1501 N Williamson Ave
Winslow, AZ 86047
Phone (928) 289-4691

500 Indiana Ave
Winslow, AZ 86047

15812 Midway Rd
Addison, TX 75001
Phone (972) 341-9265

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

Organizations & group practices 7

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": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1265410351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15070",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852675070",
            "telephone_number": "602-839-6968",
            "fax_number": "602-839-4144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 E MCDOWELL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062612",
            "telephone_number": "602-839-6968",
            "fax_number": "602-839-4144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOGNACCI",
        "first_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MI",
            "license": "5101015106",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "5101015106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.