Individual provider Active NPI

Macelle L Neuwirth, M.D.

  • Pediatrics Physician
  • Peoria, AZ
National Provider Identifier
1407841471
Registry record updated Jan 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
34319 Issued in AZ
Practice address
6780 W Thunderbird Rd # A101
Peoria, AZ 85381-5049
Phone
(602) 843-1991
Fax
(602) 843-3224
NPI assigned
Sep 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 34319 AZ Primary

Addresses

Primary practice location

6780 W Thunderbird Rd # A101
Peoria, AZ 85381-5049

Mailing address

5757 W Thunderbird Rd
E 255
Glendale, AZ 85306-4641
Phone (602) 843-1991

Other identifiers 1

IdentifierTypeStateIssuer
951170MedicaidAZ

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
I20110519000053 AZ Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 8820274277

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Medical Group, LTD Pediatrics Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1407841471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5757 W THUNDERBIRD RD",
            "address_2": "E 255",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064641",
            "telephone_number": "602-843-1991",
            "fax_number": "602-843-3224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6780 W THUNDERBIRD RD # A101",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815049",
            "telephone_number": "602-843-1991",
            "fax_number": "602-843-3224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEUWIRTH",
        "first_name": "MACELLE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-15",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "34319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "951170",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.