Active NPI
Charles C Otuonye, M.D.
- Hospitalist Physician
- Glendale, AZ
National Provider Identifier
1265444913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 34756
- Practice address
- 5555 W. Thunderbird
Banner Thunderbird Medical Center
Glendale, AZ 85306 - Phone
- (602) 865-2627
- Fax
- (602) 865-2632
- NPI assigned
- Aug 12, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 34756 | AZ | |
| Hospitalist Physician | 208M00000X | 34756 | AZ | Primary |
Addresses
Primary practice location
5555 W. Thunderbird
Banner Thunderbird Medical Center
Glendale, AZ 85306
Mailing address
5555 W. Thunderbird
Banner Thunderbird Medical Center
Glendale, AZ 85306
Phone (602) 865-2627
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 124359 | Medicaid | AZ |
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
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
350 W Thomas Rd
Phoenix, AZ 85013-4409
Phone (602) 406-3000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Zion Medical Group PLLC | Internal Medicine | Current | Accepting new patients |
| Dignity Health | Past | Accepting new patients | |
| Reunion Rehabilitation Hospital Peoria, LLC | Past | Accepting new patients | |
| Ipn of Arizona, PLC | Internal Medicine | Past | Accepting new patients |
Locations
7300 N 99th Ave
Glendale, AZ 85307
Phone (480) 339-5001
350 W Thomas Rd
Phoenix, AZ 85013
Phone (480) 339-5001
Organizations & group practices 4
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.
-
- General Acute Care Hospital
- Glendale, AZ
- NPI 1992131734
-
- Internal Medicine Physician
- Glendale, AZ
- NPI 1538119284
-
- Rehabilitation Hospital
- Peoria, AZ
- NPI 1922723121
Hospital & facility affiliations 17
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Laveen, AZ
- NPI 1154748416
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483488000000",
"number": "1265444913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5555 W. THUNDERBIRD",
"address_2": "BANNER THUNDERBIRD MEDICAL CENTER",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "85306",
"telephone_number": "602-865-2627",
"fax_number": "602-865-2632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5555 W. THUNDERBIRD",
"address_2": "BANNER THUNDERBIRD MEDICAL CENTER",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "85306",
"telephone_number": "602-865-2627",
"fax_number": "602-865-2632"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTUONYE",
"first_name": "CHARLES",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-12",
"last_updated": "2017-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AZ",
"license": "34756",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "AZ",
"license": "34756",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "124359",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2017; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.