Individual provider Active NPI

Trenton Ross Hubbard, M.D.

  • Child Abuse Pediatrics Physician
  • Phoenix, AZ
National Provider Identifier
1487919155
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child Abuse Pediatrics PhysicianTaxonomy code 2080C0008X
License
73222 Issued in AZ
Practice address
2120 N Central Ave
Phoenix, AZ 85004-1455
Phone
(602) 933-6100
Fax
(602) 933-2422
NPI assigned
Jul 9, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 125062383 IL
Pediatrics Physician 208000000X A167536 CA
Child Abuse Pediatrics Physician 2080C0008X A167536 CA
Child Abuse Pediatrics Physician 2080C0008X 73222 AZ Primary

Addresses

Primary practice location

2120 N Central Ave
Phoenix, AZ 85004-1455

Mailing address

2108 E Thomas Rd Ste 130
Phoenix, AZ 85016-0008
Phone (602) 933-3124

Other practice location 1

1125 E Spruce Ave Ste 101
Fresno, CA 93720-3387
Phone (559) 256-5760

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, 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
I20200226002545 CA Practitioner - Pediatric MedicinePractitioner - Other (Physician) 7911203617 Reassigns benefits to 1 organization
I20240909002589 AZ Practitioner - Pediatric Medicine 7911203617 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A167536CAMDPediatrics Physician
125062383ILMDPediatrics Physician
7322AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Children'S Hospital Pediatrics Current Accepting new patients
Phoenix Children'S Medical Group CurrentSince Aug 9, 2024 Accepting new patients
Mountain Park Health Center CurrentSince Jan 5, 2026 Accepting new patients
Valley Children'S Medical Group Pediatrics CurrentSince Feb 24, 2020 Accepting new patients
Mountain Park Health Center CurrentSince Jan 5, 2026 Accepting new patients
Phoenix Children'S Medical Group CurrentSince Aug 9, 2024 Accepting new patients
Mountain Park Health Center - Dental Past Accepting new patients

Locations

1665 N Avondale Blvd
Avondale, AZ 85392
Phone (602) 933-0005

6975 W Glendale Ave
Glendale, AZ 85303
Phone (480) 729-0905

19007 N 67th Ave
Glendale, AZ 85308
Phone (602) 933-0777

140 N Litchfield Rd
Ste 200106
Goodyear, AZ 85338
Phone (623) 936-6795

3830 E Van Buren St
Phoenix, AZ 85008
Phone (602) 806-6655

3003 N Central Ave
Ste 1600
Phoenix, AZ 85012
Phone (602) 323-3492

5517 N 17th Ave
Phoenix, AZ 85015
Phone (602) 242-7717

6601 W Thomas Rd
Phoenix, AZ 85033

2108 E Thomas Rd
Ste 130
Phoenix, AZ 85016

303 E Baseline Rd
Phoenix, AZ 85042
Phone (602) 277-6181

635 E Baseline Rd
Phoenix, AZ 85042

4315 N Maryvale Pkwy
Phoenix, AZ 85031
Phone (623) 691-1700

2120 N Central Ave
Phoenix, AZ 85004
Phone (602) 271-4500

1300 N 48th St
Phoenix, AZ 85008
Phone (480) 882-5917

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

1840 E Broadway Rd
Tempe, AZ 85282
Phone (602) 323-3444

1125 E Spruce Ave
Ste 101
Fresno, CA 93720
Phone (559) 256-5760

9300 Valley Childrens Pl
#5
Madera, CA 93636
Phone (559) 353-5700

1524 McHenry Ave
Ste 550570
Modesto, CA 95350
Phone (209) 572-3880

Organizations & group practices 7

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": "1341792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1487919155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 E THOMAS RD STE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850160008",
            "telephone_number": "602-933-3124",
            "fax_number": "559-353-5708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 N CENTRAL AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041455",
            "telephone_number": "602-933-6100",
            "fax_number": "602-933-2422"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1125 E Spruce Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937203387",
            "country_code": "US",
            "telephone_number": "559-256-5760",
            "fax_number": "559-256-5761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUBBARD",
        "first_name": "TRENTON",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-09",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125062383",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A167536",
            "primary": false
        },
        {
            "code": "2080C0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Child Abuse Pediatrics",
            "state": "CA",
            "license": "A167536",
            "primary": false
        },
        {
            "code": "2080C0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Child Abuse Pediatrics",
            "state": "AZ",
            "license": "73222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.