Justin David Dufner, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

6687 Issued in AZ

Practice address

1917 S Crismon Rd
Mesa, AZ 85209-6216

Phone

(480) 610-7100

Fax

(480) 610-7115

NPI assigned

Apr 28, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Family Practice

Education

New York College of Osteo Medicine of New York Institute of Technology, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Banner Primary Care Physicians Arizona LLCGroup PAC ID 6406020155, 236 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Home Care-Arizona Home health agency, Mesa, AZ, CCN 037015
• Banner Baywood Medical Center Hospital, Mesa, AZ, CCN 030088
• Banner Gateway Medical Center Hospital, Gilbert, AZ, CCN 030122
• Banner Desert Medical Center Hospital, Mesa, AZ, CCN 030065
• Banner Heart Hospital Hospital, Mesa, AZ, CCN 030105

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Banner Primary Care Physicians Arizona LLC

  • Primary Care Clinic/Center
  • Phoenix, AZ
  • NPI 1659640902
  Medicare reassignment Care Compare group NPD
• Banner Primary Care Physicians Arizona LLC

  • Primary Care Clinic/Center
  • Phoenix, AZ
  • NPI 1417238908
  NPD
• Banner Primary Care Physicians Arizona LLC

  • Primary Care Clinic/Center
  • Phoenix, AZ
  • NPI 1790306066
  NPD
• Kay County Clinic Company LLC

  • Family Medicine Physician
  • Ponca City, OK
  • NPI 1225072796
  NPD (past)

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

• Banner Baywood Medical Center

  • General Acute Care Hospital
  • Mesa, AZ
  • NPI 1194758284
  Care Compare affiliation
• Banner Desert Medical Center

  • General Acute Care Hospital
  • Mesa, AZ
  • NPI 1720011810
  Care Compare affiliation
• Banner Gateway Medical Center

  • General Acute Care Hospital
  • Gilbert, AZ
  • NPI 1699884858
  Care Compare affiliation
• Banner Heart Hospital

  • Special Hospital
  • Mesa, AZ
  • NPI 1215961248
  Care Compare affiliation
• Banner Home Care-Arizona

  • Home Health Agency
  • Sun City, AZ
  • NPI 1023051927
  Care Compare affiliation

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

{
    "created_epoch": "1335571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441238400000",
    "number": "1457619371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1917 S CRISMON RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852096216",
            "telephone_number": "480-610-7100",
            "fax_number": "480-610-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1917 S CRISMON RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852096216",
            "telephone_number": "480-610-7100",
            "fax_number": "480-610-7115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUFNER",
        "first_name": "JUSTIN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-28",
        "last_updated": "2015-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A11831",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "5204",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "6687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charity Duerksen
• Nathan Rex Duffin, D.O.
• Evan Duffy, MD
• Kyle Duffy
• Rachel Duffy
• Carysa Malaret Dugan, PT
• Shannon L Duggan, MD
• Roberta Cheryl Dugi, MEDICAL ASSISTANT
• Henriette Duhozanye
• Jacob Duke, DPT

• Family Medicine Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.