Individual provider Active NPI

Edward P Fink, M.D.

  • Pediatric Orthopaedic Surgery Physician
  • Glendale, AZ
National Provider Identifier
1437117835
Registry record updated Feb 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X
License
46045 Issued in AZ
Practice address
5310 W Thunderbird Rd
Suite 110
Glendale, AZ 85306-4706
Phone
(602) 865-4510
NPI assigned
May 3, 2006
Last updated
Feb 12, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2013

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 0101248481 VA
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 0101248481 VA
Orthopaedic Trauma Physician 207XX0801X 0101248481 VA
Pediatric Orthopaedic Surgery Physician 207XP3100X 0101248481 VA
Pediatric Orthopaedic Surgery Physician 207XP3100X 46045 AZ Primary

Addresses

Primary practice location

5310 W Thunderbird Rd
Suite 110
Glendale, AZ 85306-4706

Mailing address

5310 W Thunderbird Rd
Suite 110
Glendale, AZ 85306-4706
Phone (602) 865-4510

Other identifiers 1

IdentifierTypeStateIssuer
683132MedicaidAZ

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 Medicine

State licenses

LicenseStateTypeSpecialty
46045AZMDPediatric Orthopaedic Surgery Physician
0101248481VAMDOrthopaedic Trauma Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Physician Super Specialists Arizona LLC Past Accepting new patients
Banner Physician Super Specialists Arizona LLC Past Accepting new patients

Organizations & group practices 3

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360627200000",
    "number": "1437117835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 W THUNDERBIRD RD",
            "address_2": "SUITE 110",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064706",
            "telephone_number": "602-865-4510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5310 W THUNDERBIRD RD",
            "address_2": "SUITE 110",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064706",
            "telephone_number": "602-865-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINK",
        "first_name": "EDWARD",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2013-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "VA",
            "license": "0101248481",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "VA",
            "license": "0101248481",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "VA",
            "license": "0101248481",
            "primary": false
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "VA",
            "license": "0101248481",
            "primary": false
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "AZ",
            "license": "46045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "683132",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2013; 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.