Jonathan J Wiggenhorn, D.O.

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

License

4738 Issued in AZ

Practice address

2700 N 140TH Avenue
Ste 107
Goodyear, AZ 85395

Phone

(623) 353-8770

Fax

(623) 353-8771

NPI assigned

Jun 23, 2006

Last updated

Aug 17, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Otolaryngology

Education

Western University of Health Sciences College of Dental Med, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Estrella Ear Nose and Throat PCGroup PAC ID 4082741087, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Estrella Medical Center Hospital, Phoenix, AZ, CCN 030115

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/7486/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir4.healow.com/fhir/r4/AFAACD

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.

• Estrella Ear, Nose and Throat PC

  • Facial Plastic Surgery Physician
  • Gilbert, AZ
  • NPI 1952623100
  Medicare reassignment Care Compare group NPD
• Andrew B Mangum MD PLLC

  • Anesthesiology Physician
  • Tempe, AZ
  • NPI 1538512496
  NPD (past)
• Bradley B Anderson MD PLLC

  • Anesthesiology Physician
  • Tempe, AZ
  • NPI 1972061927
  NPD (past)
• Jatinder Somal MD PC

  • Anesthesiology Physician
  • Tempe, AZ
  • NPI 1790005916
  NPD (past)
• Premier Ear, Nose and Throat Surgeons, LTD

  • Otolaryngology Physician
  • Phoenix, AZ
  • NPI 1265651947
  NPD (past)
• Secure Anesthesia PLLC

  • Specialist
  • Tempe, AZ
  • NPI 1720113145
  NPD (past)
• Vigilance Anesthesiology Physician Resources PLLC

  • Anesthesiology Physician
  • Tempe, AZ
  • NPI 1306577721
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Banner Estrella Medical Center

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1275566200
  Care Compare affiliation

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1417983230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 N 140TH AVE STE 107",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952439",
            "telephone_number": "623-537-7085",
            "fax_number": "623-535-8771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 N 140TH AVENUE",
            "address_2": "STE 107",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "85395",
            "telephone_number": "623-353-8770",
            "fax_number": "623-353-8771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14506 W Granite Valley Dr Ste 124",
            "address_purpose": "LOCATION",
            "city": "Sun City West",
            "state": "AZ",
            "postal_code": "853756012",
            "country_code": "US",
            "telephone_number": "623-535-8770",
            "fax_number": "623-535-8771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIGGENHORN",
        "first_name": "JONATHAN",
        "middle_name": "J",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "AZ",
            "license": "4738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "272504",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert P Whitehead, MD
• Cheryl Lea Whiting
• Aimee Benton Wickersham, LCSW
• Erich A Widemark, PHD, FNP-BC
• Michele Wiest-Alvarez
• Wild West Orthodontics Inc.
• Wild West Orthodontics P.C (Wild West Orthodontics)
• Maria Elizabeth Wildey, LCSW
• Wildflower Therapy Services LLC
• Katrina Mae Wiley, WHNP-BC, RNC-OB

• Facial Plastic Surgery Physician in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Facial Plastic Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.