Organization Active NPI

Mark Winograd, M.D., P.C.

  • Neurology Physician
  • Glendale, AZ
National Provider Identifier
1306029566
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
13992 Issued in AZ
Legal business name
MARK WINOGRAD, M.D., P.C.
Practice address
5757 W Thunderbird Rd
Suite E151
Glendale, AZ 85306-4685
Phone
(602) 843-3811
Fax
(602) 843-0044
NPI assigned
Dec 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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

Authorized official

Name
Dr. Mark Winograd, M.D.
Title
President
Phone
(602) 843-3811

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X 13992 AZ Primary

Addresses

Primary practice location

5757 W Thunderbird Rd
Suite E151
Glendale, AZ 85306-4685

Mailing address

5757 W Thunderbird Rd
Suite E151
Glendale, AZ 85306-4641
Phone (602) 843-3811

Other identifiers 1

IdentifierTypeStateIssuer
206400-01MedicaidAZ

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325635200000",
    "number": "1306029566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5757 W THUNDERBIRD RD",
            "address_2": "SUITE E151",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064641",
            "telephone_number": "602-843-3811",
            "fax_number": "602-843-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5757 W THUNDERBIRD RD",
            "address_2": "SUITE E151",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064685",
            "telephone_number": "602-843-3811",
            "fax_number": "602-843-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK WINOGRAD, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-11",
        "last_updated": "2012-01-04",
        "status": "A",
        "authorized_official_last_name": "WINOGRAD",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "602-843-3811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AZ",
            "license": "13992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206400-01",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.