Individual provider Active NPI

Luis Vazquez, D.O.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Phoenix, AZ
National Provider Identifier
1437387883
Registry record updated Jan 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
006403 Issued in AZ
Practice address
2340 E Beardsley Rd
Suite 260
Phoenix, AZ 85024-1285
Phone
(602) 802-8240
Fax
(602) 802-8245
NPI assigned
Jun 24, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 5101018092 MI
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 006403 AZ Primary

Addresses

Primary practice location

2340 E Beardsley Rd
Suite 260
Phoenix, AZ 85024-1285

Mailing address

2340 E Beardsley Rd
Suite 260
Phoenix, AZ 85024-1285
Phone (602) 802-8240

Other identifiers 1

IdentifierTypeStateIssuer
923114MedicaidAZ

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
I20140827002967 AZ Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 8022236389 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
Arizona College of Osteopathic Medicine Mid Western University, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite ENTGroup PAC ID 5890073803, 2 clinicians

Practice addresses (Care Compare)

2340 E Beardsley Rd
Suite 260
Phoenix, AZ 85024-1287
Phone (602) 802-8240

Hospital & facility affiliations

  • Honorhealth Deer Valley Medical Center Hospital, Phoenix, AZ, CCN 030092

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101018092MIMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Happy Kids Pediatrics P.C. Current Accepting new patients
Elite ENT Otolaryngology CurrentSince Dec 1, 2016 Accepting new patients
Pinnacle ENT & Allergy Consultants LLC PastSince Jul 1, 2019 Accepting new patients

Locations

1033 N Arizona Ave
Chandler, AZ 85225
Phone (480) 300-4741

6710 W Camelback Rd
Ste A
Glendale, AZ 85303

1345 E Main St
Ste 104
Mesa, AZ 85203
Phone (480) 300-4741

1157 S Crismon Rd
Unit 102
Mesa, AZ 85208

1311 E Thomas Rd
Phoenix, AZ 85014
Phone (602) 322-1315

2340 E Beardsley Rd
Ste 260
Phoenix, AZ 85024
Phone (602) 482-0756

825 W Southern Ave
Ste 106
Phoenix, AZ 85041
Phone (602) 243-3429

3415 W Glendale Ave
Ste 32A
Phoenix, AZ 85051
Phone (602) 246-7462

2033 E Warner Rd
Ste 109
Tempe, AZ 85284
Phone (480) 820-5525

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CDAIAD/Endpoint/CDAIAD
  • FHIR API: https://fhir4.healow.com/fhir/r4/CDAIAD

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484179200000",
    "number": "1437387883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2340 E BEARDSLEY RD",
            "address_2": "SUITE 260",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850241285",
            "telephone_number": "602-802-8240",
            "fax_number": "602-802-8245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2340 E BEARDSLEY RD",
            "address_2": "SUITE 260",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850241285",
            "telephone_number": "602-802-8240",
            "fax_number": "602-802-8245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-24",
        "last_updated": "2017-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "MI",
            "license": "5101018092",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "AZ",
            "license": "006403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "923114",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.