Individual provider Active NPI

Ryan B Golub, D.P.M.

  • Podiatrist
  • Phoenix, AZ
National Provider Identifier
1285635888
Registry record updated Mar 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
0581 Issued in AZ
Practice address
11209 N Tatum Blvd Ste B100
Phoenix, AZ 85028-3091
Phone
(602) 973-3888
Fax
(602) 973-3028
NPI assigned
Aug 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 0581 AZ Primary

Addresses

Primary practice location

11209 N Tatum Blvd Ste B100
Phoenix, AZ 85028-3091

Mailing address

11209 N Tatum Blvd Ste B100
Phoenix, AZ 85028-3091
Phone (602) 973-3888

Other identifiers 2

IdentifierTypeStateIssuer
AZ0194890OtherAZBCBS
2Z0183OtherAZHEALTH NET

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100203000460 AZ Practitioner - Podiatry 4587707286 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1998
Medicare assignment
May accept Medicare assignment
Group practices
Arizona Foot Health PCGroup PAC ID 1254316540, 2 clinicians

Practice addresses (Care Compare)

11209 N Tatum Blvd
Suite B100
Phoenix, AZ 85028-3091

Merit-based Incentive Payment System (MIPS)

Final score
83.34 of 100Reported as individual
Quality
69.7
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue14
Removal of skin lesions1-10
Removal of nail tissue680
Removal or shaving of skin growth424

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0581AZMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Foot Health, P.C. Podiatrist CurrentSince Jun 18, 2003 Accepting new patients
Canyon Ambulatory Surgery Center, LLC PastSince Mar 31, 2014 Accepting new patients

Locations

11209 N Tatum Blvd
Ste B100
Phoenix, AZ 85028
Phone (602) 973-3888

11209 N Tatum Blvd
Phoenix, AZ 85028
Phone (480) 285-2180

Interoperability endpoints

  • Direct secure messaging: ryan.golub.1@18608.direct.athenahealth.com
  • Direct secure messaging: ryan.golub@358.chartlogic.direct-ci.com
  • FHIR API: https://api.platform.athenahealth.com/18608/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1285635888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11209 N TATUM BLVD STE B100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850283091",
            "telephone_number": "602-973-3888",
            "fax_number": "602-973-3028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11209 N TATUM BLVD STE B100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850283091",
            "telephone_number": "602-973-3888",
            "fax_number": "602-973-3028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLUB",
        "first_name": "RYAN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-03",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "AZ",
            "license": "0581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0194890",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "2Z0183",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.