Individual provider Active NPI

James W Groff, DO

  • Dermatology Physician
  • Sun City West, AZ
National Provider Identifier
1265480644
Registry record updated Oct 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
2203 Issued in AZ
Practice address
14506 W Granite Valley Dr
124
Sun City West, AZ 85375-6010
Phone
(623) 584-2127
Fax
(623) 584-1257
NPI assigned
May 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 2203 AZ Primary

Addresses

Primary practice location

14506 W Granite Valley Dr
124
Sun City West, AZ 85375-6010

Mailing address

13943 N 91St Ave
#C-101
Peoria, AZ 85381-3629
Phone (623) 760-9449

Other identifiers 10

IdentifierTypeStateIssuer
1265480644OtherAZAHCCCS
99S007000002OtherAZMEDISUN
188961600OtherAZDEPT OF LABOR WORK COMP
378796OtherAZUNITED HEALTHCARE
000378796OtherAZEVERCARE
070003071OtherAZRAILROAD MEDICARE
0956762OtherAZAETNA
113738MedicaidAZ
AZ0223100OtherAZBLUE CROSS BLUE SHIELD
1Z2644OtherAZHEALTH NET

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)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2203AZMDEmergency Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380844800000",
    "number": "1265480644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13943 N 91ST AVE",
            "address_2": "#C-101",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853813629",
            "telephone_number": "623-760-9449",
            "fax_number": "623-974-9351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14506 W GRANITE VALLEY DR",
            "address_2": "124",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853756010",
            "telephone_number": "623-584-2127",
            "fax_number": "623-584-1257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROFF",
        "first_name": "JAMES",
        "middle_name": "W",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2013-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "2203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "1265480644",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDISUN",
            "identifier": "99S007000002",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR WORK COMP",
            "identifier": "188961600",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "378796",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "000378796",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "070003071",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0956762",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113738",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "AZ0223100",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "1Z2644",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City West, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2013; 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.