Active NPI
Joseph A Mabilia, D.O.
- Family Medicine Physician
- Phoenix, AZ
National Provider Identifier
1417150285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 1684
- Practice address
- 3440 W. Cactus Road
Phoenix, AZ 85029-2238 - Phone
- (602) 249-3380
- Fax
- (602) 973-0978
- NPI assigned
- Jun 7, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 1684 | AZ | Primary |
Addresses
Primary practice location
3440 W. Cactus Road
Phoenix, AZ 85029-2238
Mailing address
PO Box 41908
Phoenix, AZ 85080-1908
Phone (602) 249-3380
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 323912 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1684 | AZ | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mehareen LLP | Family Medicine | 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.
-
- Family Medicine Physician
- Phoenix, AZ
- NPI 1134118656
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1256169600000",
"number": "1417150285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 41908",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850801908",
"telephone_number": "602-249-3380",
"fax_number": "602-973-0978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3440 W. CACTUS ROAD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850292238",
"telephone_number": "602-249-3380",
"fax_number": "602-973-0978"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MABILIA",
"first_name": "JOSEPH",
"middle_name": "A",
"name_prefix": "Mr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-07",
"last_updated": "2009-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AZ",
"license": "1684",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "323912",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.