Individual provider Active NPI

Elizabeth Collyer, MD

  • Pediatric Gastroenterology Physician
  • Phoenix, AZ
National Provider Identifier
1326369307
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
52100 Issued in AZ
Practice address
1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone
(602) 933-0940
Fax
(602) 933-2424
NPI assigned
Jun 14, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MT197319 PA
Pediatrics Physician 208000000X MD447010 PA
Pediatric Gastroenterology Physician 2080P0206X 57.022304 OH
Pediatric Gastroenterology Physician 2080P0206X 52100 AZ Primary

Addresses

Primary practice location

1919 E Thomas Rd
Phoenix, AZ 85016-7710

Mailing address

3200 E Camelback Rd Ste 250
Phoenix, AZ 85018-2327

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160609000026 AZ Practitioner - Gastroenterology 8820388523 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Pennsylvania State University College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Children'S HospitalGroup PAC ID 0446278584, 431 clinicians

Practice addresses (Care Compare)

1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone (602) 933-0930

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD447010PAMDPediatrics Physician
MT197319PAMDPediatrics Physician
57.022304OHMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc CurrentSince Mar 1, 2021 Accepting new patients
Phoenix Children'S Medical Group CurrentSince Jul 1, 2016 Accepting new patients
Phoenix Children'S Hospital Pediatrics CurrentSince Jul 1, 2016 Accepting new patients
District Medical Group, Inc Current Accepting new patients
District Medical Group, Inc CurrentSince Mar 1, 2021 Accepting new patients

Locations

1665 N Avondale Blvd
Avondale, AZ 85392
Phone (602) 933-0005

6524 W Sack Dr
Ste 201
Glendale, AZ 85308
Phone (602) 933-0935

20325 N 51st Ave
Ste 116
Glendale, AZ 85308
Phone (602) 933-1010

5131 E Southern Ave
Mesa, AZ 85206
Phone (480) 833-5437

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

3200 E Camelback Rd
Ste 250
Phoenix, AZ 85018
Phone (602) 933-1814

Organizations & group practices 5

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": "1276473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1326369307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 E CAMELBACK RD STE 250",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-933-0940",
            "fax_number": "602-933-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLYER",
        "first_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-14",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT197319",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD447010",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "OH",
            "license": "57.022304",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "AZ",
            "license": "52100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.