Organization Active NPI

Arrowhead Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Chandler, AZ
National Provider Identifier
1336687326
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
ARROWHEAD SURGERY CENTER
Practice address
1500 W Ray Rd
Chandler, AZ 85224-0002
Phone
(480) 963-3881
Fax
(480) 899-8610
NPI assigned
Feb 9, 2017
Last updated
Dec 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Authorized official

Name
Dr. Michael Jerome Depenbusch, M.D.NPI 1003897794
Title
President/Owner
Phone
(480) 272-2686

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

1500 W Ray Rd
Chandler, AZ 85224-0002

Mailing address

1500 W Ray Rd
Chandler, AZ 85224-0002
Phone (480) 963-3881

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170920000050 AZ Part B Supplier - Ambulatory Surgical Center 5799059424 Practice locations: Chandler, AZ

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Arrowhead Surgery Center LLCCCN 03C0001386
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2131823Arrowhead Surgery Center1500 W Ray Rd, Ste 2, Chandler, AZ 85224Certificate of waiverJun 5, 2027

National Provider Directory

National Provider Directory

Locations

1500 W Ray Rd
#2
Chandler, AZ 85224

1500 W Ray Rd
Ste 2
Chandler, AZ 85224
Phone (480) 427-3800

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1486598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733097600000",
    "number": "1336687326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 W RAY RD",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852240002",
            "telephone_number": "480-963-3881",
            "fax_number": "480-899-8610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W RAY RD",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852240002",
            "telephone_number": "480-963-3881",
            "fax_number": "480-899-8610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARROWHEAD SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-09",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A",
        "authorized_official_last_name": "DEPENBUSCH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JEROME",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "480-272-2686",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.