NPIMap

Individual provider Active NPI

Michael J. Labenz, M.D.

  • Diagnostic Radiology Physician
  • Flagstaff, AZ
National Provider Identifier
1386699643
Registry record updated Apr 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
28423 Issued in AZ
Practice address
77 W. Forest Avenue
Suite 101
Flagstaff, AZ 86001-1482
Phone
(928) 773-2215
Fax
(928) 773-2240
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 28423 AZ Primary

Addresses

Primary practice location

77 W. Forest Avenue
Suite 101
Flagstaff, AZ 86001-1482

Mailing address

Dept 2018
PO Box 29675
Phoenix, AZ 85038-9675

Other identifiers 1

IdentifierTypeStateIssuer
621442MedicaidAZ

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
I20040608000379 AZ Practitioner - Diagnostic Radiology 6305828641 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Creighton University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Arizona Radiology P CGroup PAC ID 4880683085, 20 clinicians

Practice addresses (Care Compare)

1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 779-3366

1501 Williamson Ave
Winslow, AZ 86047-2735
Phone (928) 289-4691

269 S Candy LN
Cottonwood, AZ 86326-4158
Phone (928) 634-2251

3700 W State Route 89a
Sedona, AZ 86336-4937
Phone (928) 204-3000

77 W Forest Ave
Suite 101
Flagstaff, AZ 86001-1482
Phone (928) 773-2515

Hospital & facility affiliations

  • Flagstaff Medical Center Hospital, Flagstaff, AZ, CCN 030023
  • Verde Valley Medical Center Hospital, Cottonwood, AZ, CCN 030007
  • Little Colorado Medical Center Hospital, Winslow, AZ, CCN 031311
  • Tuba City Regional Health Care Corporation Hospital, Tuba City, AZ, CCN 030073
  • Page Hospital Hospital, Page, AZ, CCN 031304

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28423AZMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Arizona Radiology P C Diagnostic Radiology CurrentSince Apr 1, 2000 Accepting new patients
Alliance Healthcare Services Inc. CurrentSince Jan 1, 2015 Accepting new patients
Navajo Health Foundation-Sage Memorial Hospital Inc Past Accepting new patients
Page Hospital Past Accepting new patients

Locations

1298 W Finnie Flat Rd
Camp Verde, AZ 86322
Phone (928) 639-5509

269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251

450 S Willard St
Ste 111
Cottonwood, AZ 86326
Phone (928) 639-6587

77 W Forest Ave
Ste 101
Flagstaff, AZ 86001
Phone (928) 773-2215

77 W Forest Ave
Ste 102
Flagstaff, AZ 86001

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235

1485 N Turquoise Dr
Flagstaff, AZ 86001
Phone (928) 774-6626

3700 W State Route 89A
Sedona, AZ 86336
Phone (928) 204-3000

301 S 7th St
Williams, AZ 86046
Phone (928) 380-2611

1501 N Williamson Ave
Winslow, AZ 86047
Phone (928) 289-4691

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.

Hospital & facility affiliations 9

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302134400000",
    "number": "1386699643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 2018",
            "address_2": "PO BOX 29675",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850389675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 W. FOREST AVENUE",
            "address_2": "SUITE 101",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011482",
            "telephone_number": "928-773-2215",
            "fax_number": "928-773-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABENZ",
        "first_name": "MICHAEL",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2011-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "28423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "621442",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.