NPIMap

Individual provider Active NPI

Ezekiel John Anderson, D.O.

  • Anesthesiology Physician
  • Glendale, AZ
National Provider Identifier
1487997763
Registry record updated Nov 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
007195 Issued in AZ
Practice address
18205 N 51St Ave Ste 109
Glendale, AZ 85308-1491
Phone
(602) 547-1400
NPI assigned
Apr 4, 2013
Last updated
Nov 22, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2017

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 007195 AZ Primary

Addresses

Primary practice location

18205 N 51St Ave Ste 109
Glendale, AZ 85308-1491

Mailing address

23363 N 61St Dr
Glendale, AZ 85310-5736

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171025002209 AZ Practitioner - Anesthesiology 1254558943 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
District Medical Group IncGroup PAC ID 7315086691, 454 clinicians

Practice addresses (Care Compare)

2601 E Roosevelt St
Phoenix, AZ 85008-4973
Phone (602) 344-5011

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.59 of 100Reported as group
Quality
81.55
Promoting interoperability
100
Improvement activities
40
Cost
79.5

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc Anesthesiology CurrentSince Mar 1, 2020 Accepting new patients
Greater Anesthesia Solutions Anesthesiology CurrentSince May 18, 2022 Accepting new patients
District Medical Group, Inc CurrentSince Mar 1, 2020 Accepting new patients
Pca Anesthesia Anesthesiology CurrentSince May 31, 2022 Accepting new patients
District Medical Group, Inc Current Accepting new patients
Parkside Anesthesia LLC Anesthesiology Current Accepting new patients
District Medical Group, Inc Anesthesiology Past Accepting new patients

Locations

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

5656 S Power Rd
Gilbert, AZ 85295
Phone (480) 840-3733

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

5880 S Hospital Dr
Globe, AZ 85501
Phone (928) 402-1217

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

8088 W Whitney Dr
Peoria, AZ 85345
Phone (602) 655-2000

1800 E Van Buren St
Phoenix, AZ 85006
Phone (602) 251-8100

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043

300 W Clarendon Ave
Ste 142
Phoenix, AZ 85013
Phone (602) 234-1803

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

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

16815 W Bell Rd
Surprise, AZ 85374
Phone (623) 244-2400

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1365033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511308800000",
    "number": "1487997763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23363 N 61ST DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853105736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18205 N 51ST AVE STE 109",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081491",
            "telephone_number": "602-547-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "EZEKIEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-04",
        "last_updated": "2017-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "007195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.