Individual provider Active NPI

Bryan W Gawley, MD

  • Plastic Surgery Physician
  • Scottsdale, AZ
National Provider Identifier
1427049873
Registry record updated May 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
33914 Issued in AZ
Practice address
8913 E. Bell Rd
BLDG E, Suite. 101-B
Scottsdale, AZ 85260
Phone
(480) 860-2173
Fax
(480) 656-9735
NPI assigned
Nov 3, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 33914 AZ Primary

Addresses

Primary practice location

8913 E. Bell Rd
BLDG E, Suite. 101-B
Scottsdale, AZ 85260

Mailing address

8913 E Bell Rd
BLDG E, Suite 101-B
Scottsdale, AZ 85260-1598
Phone (480) 860-2173

Other identifiers 1

IdentifierTypeStateIssuer
948846MedicaidAZ

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
I20050816001028 AZ Practitioner - Plastic and Reconstructive Surgery 2163452442 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
City of Hope Medical Group of Arizona LLC CurrentSince Feb 1, 2018 Accepting new patients
St. Joseph'S Hospital and Medical Center PastSince Aug 30, 2020 Accepting new patients
North Scottsdale Outpatient Surgery Center, L.L.C. Past Accepting new patients
Sjhmc Physician Services Past Accepting new patients

Locations

14200 W Celebrate Life Way
Goodyear, AZ 85338
Phone (623) 207-3000

6897 Paysphere Cir
Chicago, IL 60674
Phone (480) 586-7542

Organizations & group practices 4

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": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241654400000",
    "number": "1427049873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8913 E BELL RD",
            "address_2": "BLDG E, SUITE 101-B",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852601598",
            "telephone_number": "480-860-2173",
            "fax_number": "480-656-9735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8913 E. BELL RD",
            "address_2": "BLDG E, SUITE. 101-B",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "85260",
            "telephone_number": "480-860-2173",
            "fax_number": "480-656-9735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAWLEY",
        "first_name": "BRYAN",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2009-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "AZ",
            "license": "33914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "948846",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.