Individual provider Active NPI

John Brian Brizendine, MD

  • Surgery Physician
  • Phoenix, AZ
National Provider Identifier
1457575813
Registry record updated Jan 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
61144 Issued in AZ
Practice address
20333 N 19TH Ave Ste 230
Phoenix, AZ 85027-9901
Phone
(480) 707-9504
Fax
(602) 581-7764
NPI assigned
Apr 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X LL 25038 SC
Surgery Physician 208600000X 2008033381 MO
Surgery Physician 208600000X 61144 AZ Primary

Addresses

Primary practice location

20333 N 19TH Ave Ste 230
Phoenix, AZ 85027-9901

Mailing address

20333 N 19TH Ave Ste 230
Phoenix, AZ 85027-9901
Phone (480) 707-9504

Other identifiers 1

IdentifierTypeStateIssuer
1457575813MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090105000442 MO Practitioner - General Surgery 7911060702 Reassigns benefits to 1 organization
I20210323001742 AZ Practitioner - General Surgery 7911060702 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Unified Surgeons PLLCGroup PAC ID 4486098795, 5 clinicians

Practice addresses (Care Compare)

20333 N 19TH Ave
Suite 230
Phoenix, AZ 85027-9901
Phone (480) 707-9504

519 Rose LN
Wickenburg, AZ 85390-1448
Phone (928) 684-4365

523 Rose LN
Wickenburg, AZ 85390-1448

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy13
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue217
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61144AZMDSurgery Physician
LL 25038SCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Unified Surgeons PLLC Surgery CurrentSince Dec 29, 2023 Accepting new patients
John Fitzgibbon Memorial Hospital, Inc. Current Accepting new patients
John Fitzgibbon Memorial Hospital Inc Current Accepting new patients
Community Hospital Association, Inc. CurrentSince Aug 1, 2025 Accepting new patients
John Fitzgibbon Memorial Hospital Inc. CurrentSince Nov 1, 2008 Accepting new patients
John Fitzgibbon Memorial Hospital, Inc. Surgery CurrentSince Nov 1, 2008 Accepting new patients

Locations

20333 N 19th Ave
Ste 230
Phoenix, AZ 85027
Phone (480) 707-9504

520 Rose Ln
Wickenburg, AZ 85390
Phone (928) 666-1197

523 Rose Ln
Wickenburg, AZ 85390
Phone (928) 668-1833

2305 S Highway 65
Bldg A
Marshall, MO 65340
Phone (660) 886-7800

2305 S Highway 65
Marshall, MO 65340
Phone (660) 831-3730

Organizations & group practices 6

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 6

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": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736035200000",
    "number": "1457575813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20333 N 19TH AVE STE 230",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850279901",
            "telephone_number": "480-707-9504",
            "fax_number": "602-581-7764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20333 N 19TH AVE STE 230",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850279901",
            "telephone_number": "480-707-9504",
            "fax_number": "602-581-7764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIZENDINE",
        "first_name": "JOHN",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2025-01-05",
        "certification_date": "2025-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "LL 25038",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2008033381",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "61144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457575813",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.