NPIMap

Individual provider Active NPI

Jeffrey A Nebelsieck, MD

  • Specialist
  • Phoenix, AZ
National Provider Identifier
1396721965
Registry record updated Mar 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
28595 Issued in AZ
Practice address
3333 E Camelback Rd Ste 122
Phoenix, AZ 85018-2323
Phone
(602) 522-1900
Fax
(602) 381-3281
NPI assigned
Dec 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 28595 AZ Primary

Addresses

Primary practice location

3333 E Camelback Rd Ste 122
Phoenix, AZ 85018-2323

Mailing address

3333 E Camelback Rd
Ste 122
Phoenix, AZ 85018-2323
Phone (602) 522-1900

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
I20101028000897 AZ Practitioner - Internal Medicine 1759575244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Hahnemann University College of Medicine, 1998
Medicare assignment
May accept Medicare assignment
Group practices
Internal Medicine of Arizona PCGroup PAC ID 4284526534, 6 clinicians

Practice addresses (Care Compare)

4840 E Indian School Rd
Suite 101
Phoenix, AZ 85018-5500
Phone (602) 522-1900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
17.64 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
58.79

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine of Arizona PC CurrentSince Jul 1, 2001 Accepting new patients

Locations

4840 E Indian School Rd
Ste 101
Phoenix, AZ 85018
Phone (602) 224-1900

3333 E Camelback Rd
Ste 122
Phoenix, AZ 85018
Phone (602) 522-1900

Organizations & group practices 1

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 8

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": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1396721965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 E CAMELBACK RD",
            "address_2": "STE 122",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182323",
            "telephone_number": "602-522-1900",
            "fax_number": "602-381-3281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 E CAMELBACK RD STE 122",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182323",
            "telephone_number": "602-522-1900",
            "fax_number": "602-381-3281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEBELSIECK",
        "first_name": "JEFFREY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AZ",
            "license": "28595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.