Individual provider Active NPI

Dennis McCracken, M.D.

  • Emergency Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1417900820
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
17027 Issued in AZ
Practice address
4524 N Maryvale Pkwy Ste 140
Phoenix, AZ 85031-1730
Phone
(623) 440-5424
NPI assigned
May 18, 2006
Last updated
May 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 17027 AZ Primary
Emergency Medicine Physician 207P00000X 23683 TN
Family Medicine Physician 207Q00000X MD0000023683 TN

Addresses

Primary practice location

4524 N Maryvale Pkwy Ste 140
Phoenix, AZ 85031-1730

Mailing address

4524 N Maryvale Pkwy Ste 140
Phoenix, AZ 85031-1730
Phone (623) 440-5424

Other practice location 1

1331 N 7th St Ste 355
Phoenix, AZ 85006-2772
Phone (480) 208-1822

Other identifiers 4

IdentifierTypeStateIssuer
3056626OtherTNBLUE CROSS
3056626OtherTNBC
930056369OtherTNRAILROAD MEDICARE
3083239MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20160727001767 TN Practitioner - Emergency Medicine 1355300468 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17027AZMDEmergency Medicine Physician
23683TNMDEmergency Medicine Physician
MD0000023683TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Waynesboro Emergency Services II, LLC Emergency Medicine Past Accepting new patients
Marshall Medial Center Past Accepting new patients
Sterling Emergency Services of the Midwest, Inc Emergency Medicine Past Accepting new patients
Emcare Physician Providers, Inc. Emergency Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dmccracken@dmi-az.direct.office.nextgen.com

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1417900820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4524 N MARYVALE PKWY STE 140",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850311730",
            "telephone_number": "623-440-5424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4524 N MARYVALE PKWY STE 140",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850311730",
            "telephone_number": "623-440-5424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1331 N 7th St Ste 355",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850062772",
            "country_code": "US",
            "telephone_number": "480-208-1822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCRACKEN",
        "first_name": "DENNIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "17027",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "23683",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD0000023683",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "3056626",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "3056626",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "930056369",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3083239",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.