Individual provider Active NPI

Michael Angelo Trujillo, M.D.

  • Gastroenterology Physician
  • Flagstaff, AZ
National Provider Identifier
1467417824
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
19201 Issued in AZ
Practice address
77 W Forest Ave
Ste 210
Flagstaff, AZ 86001-1479
Phone
(928) 773-2547
Fax
(928) 773-2548
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 19201 AZ Primary

Addresses

Primary practice location

77 W Forest Ave
Ste 210
Flagstaff, AZ 86001-1479

Mailing address

77 W Forest Ave
Ste 210
Flagstaff, AZ 86001-1479
Phone (928) 773-2547

Other identifiers 1

IdentifierTypeStateIssuer
298572MedicaidAZ

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
I20110601000906 AZ Practitioner - Gastroenterology 7911898440 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
22.54 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
75.12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19201AZMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Arizona Gastroenterology Gastroenterology CurrentSince Jan 2, 1990 Accepting new patients
Flagstaff Surgical Associates PA CurrentSince Jan 28, 2025 Accepting new patients

Locations

77 W Forest Ave
Ste 201
Flagstaff, AZ 86001
Phone (928) 773-2222

560 N Switzer Canyon Dr
Flagstaff, AZ 86001
Phone (928) 774-3044

77 W Forest Ave
Ste 210
Flagstaff, AZ 86001
Phone (602) 773-2547

3700 W State Route 89A
Sedona, AZ 86336
Phone (928) 204-3000

Interoperability endpoints

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1467417824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 W FOREST AVE",
            "address_2": "STE 210",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011479",
            "telephone_number": "928-773-2547",
            "fax_number": "928-773-2548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 W FOREST AVE",
            "address_2": "STE 210",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011479",
            "telephone_number": "928-773-2547",
            "fax_number": "928-773-2548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUJILLO",
        "first_name": "MICHAEL",
        "middle_name": "ANGELO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AZ",
            "license": "19201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "298572",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.