Individual provider Active NPI

Joseph A Mabilia, D.O.

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1417150285
Registry record updated Oct 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1684 Issued in AZ
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

Updated by the provider on Oct 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
323912MedicaidAZ

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

LicenseStateTypeSpecialty
1684AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.