Individual provider Active NPI

Brunilda A Rosario, DO

  • Obstetrics & Gynecology Physician
  • Goodyear, AZ
National Provider Identifier
1366497505
Registry record updated Jan 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
4107 Issued in AZ
Practice address
700 N Estrella Pkwy
Ste 125
Goodyear, AZ 85338-9271
Phone
(623) 536-2413
Fax
(623) 536-2909
NPI assigned
May 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 4107 AZ Primary

Addresses

Primary practice location

700 N Estrella Pkwy
Ste 125
Goodyear, AZ 85338-9271

Mailing address

11435 W Buckeye Rd
Ste 104-450
Avondale, AZ 85323-6812
Phone (623) 536-2413

Other identifiers 1

IdentifierTypeStateIssuer
890378MedicaidAZ

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
I20040924000041 AZ Practitioner - Obstetrics/GynecologyPractitioner - Osteopathic Manipulative Medicine 9830167055 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
New York College of Osteo Medicine of New York Institute of Technology, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

700 N Estrella Pkwy
Suite 125
Goodyear, AZ 85338-9271
Phone (623) 536-2413

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New Start Womens Care PLC Obstetrics & Gynecology CurrentSince May 4, 2011 Accepting new patients
Banner Estrella Medical Center Past Accepting new patients

Locations

11435 W Buckeye Rd
Ste 104450
Avondale, AZ 85323

700 N Estrella Pkwy
Ste 125
Goodyear, AZ 85338
Phone (623) 536-2413

13645 W Indian School Rd
Ste B
Litchfield Park, AZ 85340
Phone (623) 536-2413

Interoperability endpoints

  • Direct secure messaging: brunilda.rosario@az021.digichart.direct-ci.com

Organizations & group practices 2

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484092800000",
    "number": "1366497505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11435 W BUCKEYE RD",
            "address_2": "STE 104-450",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853236812",
            "telephone_number": "623-536-2413",
            "fax_number": "623-536-2909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 N ESTRELLA PKWY",
            "address_2": "STE 125",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853389271",
            "telephone_number": "623-536-2413",
            "fax_number": "623-536-2909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSARIO",
        "first_name": "BRUNILDA",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2017-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "4107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890378",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

Verify at the official NPI Registry.