Organization Active NPI

Estrella Pkwy Medical Center

  • General Practice Physician
  • Goodyear, AZ
National Provider Identifier
1487920104
Registry record updated Mar 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
19987 Issued in AZ
Legal business name
ESTRELLA PKWY MEDICAL CENTER
Practice address
530 N. Estrella Pkwy
C-1
Goodyear, AZ 85338-4138
Phone
(623) 932-9211
NPI assigned
Mar 27, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2012

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

Authorized official

Name
Brion MuscarellaNPI 1043264187
Title
Manager
Phone
(623) 932-9211

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 7681 AZ
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X 19987 AZ Primary

Addresses

Primary practice location

530 N. Estrella Pkwy
C-1
Goodyear, AZ 85338-4138

Mailing address

530 N. Estrella Pkwy
C-1
Goodyear, AZ 85338-4138

National Provider Directory

National Provider Directory

Locations

530 N Estrella Pkwy
Ste C1
Goodyear, AZ 85338
Phone (623) 882-3598

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332806400000",
    "number": "1487920104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 N. ESTRELLA PKWY",
            "address_2": "C-1",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853384138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 N. ESTRELLA PKWY",
            "address_2": "C-1",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853384138",
            "telephone_number": "623-932-9211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESTRELLA PKWY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-27",
        "last_updated": "2012-03-27",
        "status": "A",
        "authorized_official_last_name": "MUSCARELLA",
        "authorized_official_first_name": "BRION",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "623-932-9211"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "7681",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "AZ",
            "license": "19987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.