Individual provider Active NPI

Matthew A Halanski, M.D.

  • Orthopaedic Surgery Physician
  • Phoenix, AZ
National Provider Identifier
1396795167
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
67575 Issued in AZ
Practice address
1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone
(602) 933-3033
Fax
(602) 933-4311
NPI assigned
May 11, 2006
Last updated
Oct 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 47367 WI
Pediatric Orthopaedic Surgery Physician 207XP3100X 678785 AZ
Orthopaedic Surgery Physician 207X00000X 67575 AZ Primary

Addresses

Primary practice location

1919 E Thomas Rd
Phoenix, AZ 85016-7710

Mailing address

2108 E Thomas Rd Ste 130
Phoenix, AZ 85016-0008
Phone (602) 933-3124

Other practice location 1

600 Highland Ave
Madison, WI 53792-0001
Phone (608) 263-6420

Other identifiers 1

IdentifierTypeStateIssuer
126213MedicaidAZ

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
I20231026000279 AZ Practitioner - Orthopedic Surgery 8921196882 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67575AZMDOrthopaedic Surgery Physician
678785AZMDPediatric Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Arizona Healthcare Corporation CurrentSince Aug 15, 2024 Accepting new patients
Phoenix Children's Medical Group CurrentSince Aug 13, 2023 Accepting new patients
Northern Arizona Healthcare Corporation Family Medicine Current Accepting new patients
Phoenix Children's Medical Group CurrentSince Aug 13, 2023 Accepting new patients
Phoenix Children's Hospital Current Accepting new patients

Locations

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

1215 N Beaver St
Ste 203
Flagstaff, AZ 86001
Phone (928) 773-2249

20325 N 51st Ave
Ste 116
Glendale, AZ 85308
Phone (602) 933-1010

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

2108 E Thomas Rd
Ste 130
Phoenix, AZ 85016

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1396795167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 E THOMAS RD STE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850160008",
            "telephone_number": "602-933-3124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-933-3033",
            "fax_number": "602-933-4311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537920001",
            "country_code": "US",
            "telephone_number": "608-263-6420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALANSKI",
        "first_name": "MATTHEW",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "47367",
            "primary": false
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "AZ",
            "license": "678785",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "67575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126213",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.