Roni Benjamin Prucz, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

52965 Issued in AZ

Practice address

9250 N 3Rd St Ste 1003
Phoenix, AZ 85020-2402

Phone

(602) 331-7811

Fax

(602) 331-5886

NPI assigned

Mar 29, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

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

Specialty

Plastic and Reconstructive Surgery

Education

Johns Hopkins University School of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Desert Medical Center Hospital, Mesa, AZ, CCN 030065
• Honorhealth Scottsdale Osborn Medical Center Hospital, Scottsdale, AZ, CCN 030038
• Honorhealth Scottsdale Shea Medical Center Hospital, Scottsdale, AZ, CCN 030087

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Phoenix Plastic Surgery, PLLC

  • Plastic and Reconstructive Surgery Physician
  • Phoenix, AZ
  • NPI 1508421819
  Medicare reassignment NPD Authorized official
• Advanced Reconstructive Surgical Associates

  • Plastic Surgery Physician
  • Phoenix, AZ
  • NPI 1437691763
  NPD

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

• Banner Desert Medical Center

  • General Acute Care Hospital
  • Mesa, AZ
  • NPI 1720011810
  Care Compare affiliation
• Honorhealth

  • General Acute Care Hospital
  • Scottsdale, AZ
  • NPI 1386608859
  Care Compare affiliation
• Honorhealth

  • General Acute Care Hospital
  • Scottsdale, AZ
  • NPI 1811951429
  Care Compare affiliation

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

{
    "created_epoch": "1238284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474243200000",
    "number": "1386886943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9250 N 3RD ST STE 1003",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202402",
            "telephone_number": "602-331-7811",
            "fax_number": "602-331-5886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9250 N 3RD ST STE 1003",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202402",
            "telephone_number": "602-331-7811",
            "fax_number": "602-331-5886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUCZ",
        "first_name": "RONI",
        "middle_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-29",
        "last_updated": "2016-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "AZ",
            "license": "52965",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "AZ",
            "license": "52965",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "AZ",
            "license": "52965",
            "primary": true
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "AZ",
            "license": "52965",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Providence Pediatrics
• Providential Western Medical
• Province Anesthesia LLC
• Abby Catherine Prow
• Proxy Medical Group PC
• Ashlee Ann Kareus Pruett, D.O.
• Laura Star Pruett, MT-BC
• Lauren Pruett, PHARM.D.
• Ashley Pruitt, RN
• Christopher R Pruitt, M.D.

• Plastic Surgery Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Plastic Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.