Active NPI
Ryan B Golub, D.P.M.
- Podiatrist
- Phoenix, AZ
National Provider Identifier
1285635888
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 0581
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AZ0194890 | Other | AZ | BCBS |
| 2Z0183 | Other | AZ | HEALTH 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
Enrollment records 1
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
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 100
- Quality
- 69.7
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 1-10 |
| Removal of tissue | 14 |
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 680 |
| Removal or shaving of skin growth | 424 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0581 | AZ | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arizona Foot Health, P.C. | Podiatrist | Current | Accepting new patients |
| Canyon Ambulatory Surgery Center, LLC | Past | 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
- ryan.golub.1@18608.direct.athenahealth.com
- ryan.golub@358.chartlogic.direct-ci.com
- 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.
-
- Durable Medical Equipment & Medical Supplies
- Phoenix, AZ
- NPI 1124112180
Podiatrist
-
- Ambulatory Surgical Clinic/Center
- Phoenix, AZ
- NPI 1689755928
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; 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.