Individual provider Active NPI

Marc Renard Brandon, M.D.

  • Anesthesiology Physician
  • Glendale, AZ
National Provider Identifier
1467431882
Registry record updated May 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
31404 Issued in AZ
Practice address
18205 N 51St Ave
Suite 109
Glendale, AZ 85308-1490
Phone
(602) 547-1400
Fax
(602) 547-1401
NPI assigned
Jan 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 31404 AZ Primary

Addresses

Primary practice location

18205 N 51St Ave
Suite 109
Glendale, AZ 85308-1490

Mailing address

18205 N 51St Ave
Suite 109
Glendale, AZ 85308-1490
Phone (602) 547-1400

Other identifiers 2

IdentifierTypeStateIssuer
Z76344OtherAZMEDICARE ID
799207MedicaidAZ

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
I20040817000717 AZ Practitioner - Anesthesiology 3678546777 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Minnesota Medical School, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner-University Medical GroupGroup PAC ID 7719899871, 1,066 clinicians
Anesthesia Partners of Arizona LLCGroup PAC ID 8628317179, 85 clinicians

Practice addresses (Care Compare)

1625 N Campbell Ave
Tucson, AZ 85719-4330
Phone (520) 694-0111

4605 E Elwood St
Suite 500
Phoenix, AZ 85040-1978
Phone (602) 200-9021

Hospital & facility affiliations

  • Banner - University Medical Center Tucson Campus Hospital, Tucson, AZ, CCN 030064

Merit-based Incentive Payment System (MIPS)

Final score
93.34 of 100Reported as apm
Quality
74.56
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group Anesthesiology Current Accepting new patients
Banner-University Medical Group CurrentSince Jun 24, 2024 Accepting new patients
Banner-University Medical Group CurrentSince Jun 24, 2024 Accepting new patients
Anesthesia Partners of Arizona LLC Anesthesiology CurrentSince Dec 1, 2021 Accepting new patients
Banner Thunderbird Medical Center Past Accepting new patients

Locations

7300 N 99th Ave
Glendale, AZ 85307
Phone (480) 339-5001

5555 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 588-5555

18701 N 67th Ave
Glendale, AZ 85308
Phone (623) 561-1000

13677 W McDowell Rd
Goodyear, AZ 85395
Phone (623) 536-4200

1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000

240 W Thomas Rd
Phoenix, AZ 85013
Phone (602) 406-3552

350 W Thomas Rd
Phoenix, AZ 85013
Phone (480) 339-5001

4605 E Elwood St
Ste 500
Phoenix, AZ 85040
Phone (469) 998-7443

1625 N Campbell Ave
Tucson, AZ 85719

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

3838 N Campbell Ave
Bldg 2
Tucson, AZ 85719

Organizations & group practices 5

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 2

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": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211846400000",
    "number": "1467431882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18205 N 51ST AVE",
            "address_2": "SUITE 109",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081490",
            "telephone_number": "602-547-1400",
            "fax_number": "602-547-1401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18205 N 51ST AVE",
            "address_2": "SUITE 109",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081490",
            "telephone_number": "602-547-1400",
            "fax_number": "602-547-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDON",
        "first_name": "MARC",
        "middle_name": "RENARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2008-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "31404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "Z76344",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "799207",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.