Individual provider Active NPI

Joseph R Mawyer, DO

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1336301035
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
006740 Issued in AZ
Practice address
15450 N Tatum Blvd
Phoenix, AZ 85032-4241
Phone
(888) 698-6727
Fax
(602) 560-2721
NPI assigned
Jun 25, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 006740 AZ Primary

Addresses

Primary practice location

15450 N Tatum Blvd
Phoenix, AZ 85032-4241

Mailing address

15450 N Tatum Blvd
Phoenix, AZ 85032-4241
Phone (888) 698-6727

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
I20111208000800 AZ Practitioner - Family Practice 6507031168 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Texas HSC, College of Osteopathic Med, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oak Street Health Physicians Group of Arizona PLLCGroup PAC ID 3274939988, 76 clinicians

Practice addresses (Care Compare)

2850 E Main St
Suite 106
Mesa, AZ 85213-9304
Phone (480) 618-0019

3536 W Glendale Ave
Phoenix, AZ 85051-8395
Phone (480) 618-0177

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
006740AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Health Physicians Group of Arizona PLLC Family Medicine CurrentSince May 20, 2024 Accepting new patients

Locations

183 W Apache Trl
Ste B109
Apache Junction, AZ 85120
Phone (480) 618-0945

2850 E Main St
Ste 106
Mesa, AZ 85213
Phone (480) 618-0019

3536 W Glendale Ave
Phoenix, AZ 85051
Phone (480) 618-0177

3820 N Oracle Rd
Tucson, AZ 85705
Phone (520) 200-6707

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.

NPI Registry JSON

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1336301035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15450 N TATUM BLVD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850324241",
            "telephone_number": "888-698-6727",
            "fax_number": "602-560-2721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15450 N TATUM BLVD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850324241",
            "telephone_number": "888-698-6727",
            "fax_number": "602-560-2721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAWYER",
        "first_name": "JOSEPH",
        "middle_name": "R",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-25",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "006740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.