Active NPI
Marek J Mazur, M.D.
- Transplant Surgery Physician
- Phoenix, AZ
National Provider Identifier
1295712172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Transplant Surgery Physician
- License
- 30610
- Practice address
- 5779 E Mayo Blvd
Phoenix, AZ 85054-4502 - Phone
- (480) 301-8000
- NPI assigned
- Dec 30, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Transplant Surgery Physician | 204F00000X | 30610 | AZ | Primary |
| Nephrology Physician | 207RN0300X | 30610 | AZ |
Addresses
Primary practice location
5779 E Mayo Blvd
Phoenix, AZ 85054-4502
Mailing address
5779 E Mayo Blvd
Phoenix, AZ 85054-4502
Phone (480) 301-8000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 708935 | Medicaid | AZ | |
| 86080015085259A812 | Other | AZ | TRIWEST |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30610 | AZ | MD | Transplant Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mayo Clinic | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Medical Laboratory
- Rochester, MN
- NPI 1083249577
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193702400000",
"number": "1295712172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5779 E MAYO BLVD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850544502",
"telephone_number": "480-301-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5779 E MAYO BLVD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850544502",
"telephone_number": "480-301-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAZUR",
"first_name": "MAREK",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-30",
"last_updated": "2007-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "204F00000X",
"taxonomy_group": "",
"desc": "Transplant Surgery",
"state": "AZ",
"license": "30610",
"primary": true
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "AZ",
"license": "30610",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "708935",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRIWEST",
"identifier": "86080015085259A812",
"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 Oct 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.