NPIMap

Organization Active NPI

District Medical Group, Inc

  • Internal Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1295968162
Registry record updated Sep 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
DISTRICT MEDICAL GROUP, INC
Practice address
2601 E Roosevelt St
Phoenix, AZ 85008-4973
Phone
(602) 344-5011
NPI assigned
Aug 26, 2009
Last updated
Sep 9, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2009

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

Authorized official

Name
Teresa Cordeiro
Title
Credentialing Manager
Phone
(602) 470-5000

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X Primary
Obstetrics & Gynecology Physician 207V00000X
Orthopaedic Surgery Physician 207X00000X
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X
Pediatrics Physician 208000000X
Psychiatry Physician 2084P0800X
Diagnostic Radiology Physician 2085R0202X
Surgery Physician 208600000X

Addresses

Primary practice location

2601 E Roosevelt St
Phoenix, AZ 85008-4973

Mailing address

2929 E Thomas Rd
Phoenix, AZ 85016-8034
Phone (602) 470-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091125000583 AZ Part B Supplier - Clinic/Group Practice 7315086691 Receives reassigned benefits from 1,603 practitioners
23 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Phoenix, AZ; Prescott, AZ; Scottsdale, AZ; Show Low, AZ; Sierra Vista, AZ; Sun City, AZ; Sun City West, AZ; Tucson, AZ…

Other NPIs on the same Medicare enrollment 23

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 23

National Provider Directory

National Provider Directory

Locations

3624 W Anthem Way
Ste C
Anthem, AZ 85086

375 E Elliot Rd
Ste 11
Chandler, AZ 85225
Phone (480) 814-7789

2940 E Banner Gateway Dr
#125
Gilbert, AZ 85234

10144 W Lake Pleasant Pkwy
Ste 1110
Peoria, AZ 85382
Phone (623) 434-5748

1101 N Central Ave
Ste 200
Phoenix, AZ 85004
Phone (602) 307-5330

1205 S 7th Ave
Phoenix, AZ 85007
Phone (602) 229-8800

2601 E Roosevelt St
#0D10
Phoenix, AZ 85008

2601 E Roosevelt St
Ste 0D10
Phoenix, AZ 85008

3033 N 44th St
Ste 120
Phoenix, AZ 85018
Phone (602) 631-3166

5031 E Washington St
Phoenix, AZ 85034
Phone (602) 386-4566

5055 E Washington St
Phoenix, AZ 85034
Phone (602) 277-1073

5650 S 35th Ave
Phoenix, AZ 85041
Phone (602) 655-6400

2450 E Show Low Lake Rd
Ste 2B
Show Low, AZ 85901
Phone (928) 537-5119

1805 N Scottsdale Rd
Tempe, AZ 85288
Phone (480) 877-3000

Practitioners & affiliated clinicians

Practitioners 1,142

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 1,142

NPI Registry JSON

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

{
    "created_epoch": "1251244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252454400000",
    "number": "1295968162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850168034",
            "telephone_number": "602-470-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 E ROOSEVELT ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850084973",
            "telephone_number": "602-344-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISTRICT MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-26",
        "last_updated": "2009-09-09",
        "status": "A",
        "authorized_official_last_name": "CORDEIRO",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "602-470-5000"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Sep 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.