NPIMap

Individual provider Active NPI

Grigory Horonenko Jr., DO

  • Pulmonary Disease Physician
  • Phoenix, AZ
National Provider Identifier
1356394035
Registry record updated Jul 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
3864 Issued in AZ
Practice address
5090 N 40TH St
Suite 122
Phoenix, AZ 85018-2111
Phone
(602) 264-5685
Fax
(602) 631-9870
NPI assigned
May 17, 2006
Last updated
Jul 21, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 3864 AZ Primary

Addresses

Primary practice location

5090 N 40TH St
Suite 122
Phoenix, AZ 85018-2111

Mailing address

5090 North 40TH St
Suite 122
Phoenix, AZ 85018
Phone (602) 264-5685

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061005000255 AZ Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 9638175219 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1111 E McDowell Rd
Phoenix, AZ 85006-2612
Phone (602) 999-6268

755 E McDowell Rd
Phoenix, AZ 85006-2506
Phone (602) 521-3086

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.53 of 100Reported as group
Quality
78.73
Promoting interoperability
98
Improvement activities
40
Cost
62.46

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Quality
69.75
Promoting interoperability
98
Improvement activities
40
Cost
68.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3864AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Banner - University Physician Specialists LLC CurrentSince Apr 2, 2024 Accepting new patients
Banner - University Physician Specialists LLC CurrentSince Apr 2, 2024 Accepting new patients
Banner - University Hospital Based Physicians LLC CurrentSince Apr 4, 2022 Accepting new patients
Camelback Pulmonary and Critical Care, PLLC Critical Care Medicine CurrentSince Jun 16, 2024 Accepting new patients
Desert Wounds, PLLC Internal Medicine CurrentSince Apr 1, 2024 Accepting new patients
Banner - University Hospital Based Physicians LLC CurrentSince Apr 4, 2022 Accepting new patients
Central Arizona Medical Associates PC Pulmonary Disease Past Accepting new patients

Locations

1012 E Willetta St
Fl 4
Phoenix, AZ 85006
Phone (602) 239-6483

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

1111 E McDowell Rd
Fl 11
Phoenix, AZ 85006
Phone (480) 564-4100

1300 N 12th St
Ste 508
Phoenix, AZ 85006
Phone (602) 839-3927

4200 E Camelback Rd
Ste 202
Phoenix, AZ 85018
Phone (602) 229-2150

755 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 271-5111

755 E McDowell Rd
Ste 202
Phoenix, AZ 85006

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279670400000",
    "number": "1356394035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5090 NORTH 40TH ST",
            "address_2": "SUITE 122",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85018",
            "telephone_number": "602-264-5685",
            "fax_number": "602-631-9870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5090 N 40TH ST",
            "address_2": "SUITE 122",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182111",
            "telephone_number": "602-264-5685",
            "fax_number": "602-631-9870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORONENKO",
        "first_name": "GRIGORY",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2010-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AZ",
            "license": "3864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.