Individual provider Active NPI

Mytia S McNeal, MD

  • Surgery Physician
  • Phoenix, AZ
National Provider Identifier
1457376436
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
33478 Issued in AZ
Practice address
16601 N 40TH St Ste 204
Phoenix, AZ 85032-3356
Phone
(602) 996-4747
Fax
(602) 953-5466
NPI assigned
Jul 12, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 33478 AZ Primary

Addresses

Primary practice location

16601 N 40TH St Ste 204
Phoenix, AZ 85032-3356

Mailing address

16601 N 40TH St Ste 204
Phoenix, AZ 85032-3356
Phone (602) 996-4747

Other identifiers 3

IdentifierTypeStateIssuer
2Z2266OtherAZAZ HEALTHNET
AZ0772090OtherAZAZ BCBS
915332MedicaidAZ

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
I20050425000775 AZ Practitioner - General Surgery 7810935392 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Wayne State University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acute Care Surgical Specialists LLCGroup PAC ID 7315106416, 17 clinicians

Practice addresses (Care Compare)

16601 N 40TH St
Suite 204
Phoenix, AZ 85032-3356
Phone (602) 633-3721

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33478AZMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Acute Care Surgical Specialists, LLC CurrentSince Apr 1, 2015 Accepting new patients
Honorhealth CurrentSince Nov 4, 2019 Accepting new patients
Honorhealth Surgery CurrentSince Nov 4, 2019 Accepting new patients
Valley Surgical Clinics, LTD Surgery CurrentSince Aug 1, 2012 Accepting new patients
Saguaro General Surgery PLLC Surgery PastSince Nov 1, 2006 Accepting new patients
Honorhealth Past Accepting new patients
Surgical Professionals, Inc Surgery Past Accepting new patients

Locations

16601 N 40th St
Ste 204
Phoenix, AZ 85032
Phone (602) 633-3721

16601 N 40th St
Ste 227
Phoenix, AZ 85032
Phone (602) 633-3721

19636 N 27th Ave
Ste 204
Phoenix, AZ 85027
Phone (480) 882-7465

19829 N 27th Ave
Phoenix, AZ 85027
Phone (602) 879-5720

250 E Dunlap Ave
Phoenix, AZ 85020
Phone (480) 331-6721

2500 W Utopia Rd
Ste 100
Phoenix, AZ 85027
Phone (623) 683-4462

3805 E Bell Rd
Ste 4800
Phoenix, AZ 85032
Phone (602) 992-3162

6036 N 19th Ave
Ste 208
Phoenix, AZ 85015
Phone (480) 896-9888

9250 N 3rd St
Ste 3015
Phoenix, AZ 85020
Phone (480) 867-7171

7400 E Osborn Rd
Scottsdale, AZ 85251
Phone (480) 481-4000

Interoperability endpoints

  • Direct secure messaging: mytiamcneal@vsc.allscriptsdirect.net

Organizations & group practices 7

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.

Hospital & facility affiliations 3

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1457376436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16601 N 40TH ST STE 204",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850323356",
            "telephone_number": "602-996-4747",
            "fax_number": "602-953-5466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16601 N 40TH ST STE 204",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850323356",
            "telephone_number": "602-996-4747",
            "fax_number": "602-953-5466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNEAL",
        "first_name": "MYTIA",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "33478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ HEALTHNET",
            "identifier": "2Z2266",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ BCBS",
            "identifier": "AZ0772090",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "915332",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.