Individual provider Active NPI

Richard Neville, M.D.

  • Vascular Surgery Physician
  • Peoria, AZ
National Provider Identifier
1457394199
Registry record updated Aug 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
22767 Issued in AZ
Practice address
13128 N 94TH Dr Ste 100
Peoria, AZ 85381-4252
Phone
(623) 259-5900
Fax
(833) 766-3364
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 22767 AZ Primary

Addresses

Primary practice location

13128 N 94TH Dr Ste 100
Peoria, AZ 85381-4252

Mailing address

10503 W Thunderbird Blvd
Suite 108
Sun City, AZ 85351-3022
Phone (623) 977-4479

Other practice location 1

10503 W Thunderbird Blvd
Suite 108
Sun City, AZ 85351-3022
Phone (623) 977-4479

Other identifiers 4

IdentifierTypeStateIssuer
313940-01MedicaidAZ
AZ0378280OtherAZBLUE CROSS/BLUE SHIELD ID #
IZ1738OtherAZHEALTHNET ID #
4216993OtherAZAETNA ID #

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
I20051129000312 AZ Practitioner - General SurgeryPractitioner - Vascular Surgery 3375563927 Practice locations: Peoria, AZ; Sun City, AZ

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Vascular Surgery
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10503 W TBRD Rd
Suite 108
Sun City, AZ 85351-3047

10503 W Thunderbird Blvd
Suite 108
Sun City, AZ 85351-3047
Phone (602) 977-4497

13128 N 94TH Dr
Suite 100
Peoria, AZ 85381-4252
Phone (623) 259-5900

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Varicose vein removal1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rajnikant T Patel MD PLLC Past Accepting new patients
Sun City Internal Medicine PLLC PastSince Jun 1, 2020 Accepting new patients

Interoperability endpoints

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

Organizations & group practices 2

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1457394199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10503 W THUNDERBIRD BLVD",
            "address_2": "SUITE 108",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853513022",
            "telephone_number": "623-977-4479",
            "fax_number": "623-977-4497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13128 N 94TH DR STE 100",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814252",
            "telephone_number": "623-259-5900",
            "fax_number": "833-766-3364"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10503 W Thunderbird Blvd",
            "address_2": "SUITE 108",
            "address_purpose": "LOCATION",
            "city": "Sun City",
            "state": "AZ",
            "postal_code": "853513022",
            "country_code": "US",
            "telephone_number": "623-977-4479",
            "fax_number": "623-977-4497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEVILLE",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "AZ",
            "license": "22767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "313940-01",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD ID #",
            "identifier": "AZ0378280",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET ID #",
            "identifier": "IZ1738",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA ID #",
            "identifier": "4216993",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.