NPIMap

Individual provider Active NPI

Edwin Mgbam, MD

  • Internal Medicine Physician
  • Sacaton, AZ
National Provider Identifier
1265492433
Registry record updated Mar 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
33253 Issued in AZ
Practice address
483 W. Seed Farm Rd.
Sacaton, AZ 85147-0038
Phone
(602) 528-1200
Fax
(602) 528-1255
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 33253 AZ Primary

Addresses

Primary practice location

483 W. Seed Farm Rd.
Sacaton, AZ 85147-0038

Mailing address

483 W. Seed Farm Rd.
Sacaton, AZ 85147-0038
Phone (602) 528-1200

Other identifiers 1

IdentifierTypeStateIssuer
88130101MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050128000863 TX Practitioner - Internal Medicine 8820064504 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ton Santa Rosa Health CenterGroup PAC ID 0749223485, 8 clinicians
Ton Sells HospitalGroup PAC ID 5092768663, 51 clinicians

Practice addresses (Care Compare)

483 W Seed Farm Rd
Hu Hu Kam Memorial Hosp
Sacaton, AZ 85147-0038
Phone (602) 528-1200

Federal Route 15 Mile Post 12
Sells, AZ 85634-8700
Phone (520) 383-5570

Highway 86 at Topawa Rd
Sells Indian Hospital
Sells, AZ 85634
Phone (520) 383-7285

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.21 of 100Reported as group
Quality
76.88
Promoting interoperability
76
Improvement activities
40
Cost
73.83

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gila River Health Care Corporation CurrentSince Nov 14, 2014 Accepting new patients
Gila River Health Care CurrentSince Nov 14, 2014 Accepting new patients
Gila River Health Care Corporation Current Accepting new patients
Ton San Simon Health Center CurrentSince May 12, 2025 Accepting new patients
Ton Sells Hospital CurrentSince May 12, 2025 Accepting new patients
Ton San Xavier Health Center CurrentSince Dec 7, 2025 Accepting new patients
Ton Santa Rosa Health Center CurrentSince May 12, 2025 Accepting new patients
Ton San Simon Health Center CurrentSince May 12, 2025 Accepting new patients
Comprehensive Hospitalist Services of Arizona LLC Past Accepting new patients
Comprehensive Hospitalist Services of Arizona, LLC Past Accepting new patients
Ton San Xavier Health Center Past Accepting new patients
Ton Sells Hospital Past Accepting new patients
Ton Santa Rosa Health Center Past Accepting new patients
Gila River Health Care Corporation Past Accepting new patients

Locations

17487 S Healthcare Dr
#H
Laveen, AZ 85339
Phone (520) 550-6000

48203 W Farrell Rd
#H
Maricopa, AZ 85139
Phone (520) 568-3881

7900 S J Stock Rd
Tucson, AZ 85746
Phone (520) 295-2550

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330646400000",
    "number": "1265492433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 W. SEED FARM RD.",
            "city": "SACATON",
            "state": "AZ",
            "postal_code": "851470038",
            "telephone_number": "602-528-1200",
            "fax_number": "602-528-1255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 W. SEED FARM RD.",
            "city": "SACATON",
            "state": "AZ",
            "postal_code": "851470038",
            "telephone_number": "602-528-1200",
            "fax_number": "602-528-1255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MGBAM",
        "first_name": "EDWIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2012-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "33253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "88130101",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacaton, AZ

Sources for this page

Verify at the official NPI Registry.