Vanessa Tartaglia-Keane, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4426 Issued in AZ

Practice address

18275 N 59TH Ave
BLDG K Suite 162
Glendale, AZ 85308-1254

Phone

(602) 547-8184

Fax

(602) 547-8339

NPI assigned

Mar 15, 2007

Last updated

Sep 14, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 12, 2020 through Nov 12, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536883200000",
    "number": "1265566061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18275 N 59TH AVE",
            "address_2": "BLDG K SUITE 162",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081254",
            "telephone_number": "602-547-8184",
            "fax_number": "602-547-8339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18275 N 59TH AVE",
            "address_2": "BLDG K SUITE 162",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081254",
            "telephone_number": "602-547-8184",
            "fax_number": "602-547-8339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20860 N Tatum Blvd Ste 290",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850504282",
            "country_code": "US",
            "telephone_number": "480-563-1144",
            "fax_number": "480-563-2371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TARTAGLIA-KEANE",
        "first_name": "VANESSA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2018-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "7057360001",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "4426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Tang
• Tannaz Malekzadeh DMD
• Sarah A Tanner, PA-C
• Briah Tarapacki
• Makenna Tarr
• John Tassone Jr., DPM
• Raven Angelic Tate
• Samantha Nicole Tatman
• Jessica L Tatum
• Irene K Taw, MD

• Family Medicine Physician in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2018; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.