Individual provider Active NPI

Carolyn Ann Hofmeister

  • Internal Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1497334692
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
72155 Issued in AZ
Practice address
1300 N 12TH St Ste 508
Phoenix, AZ 85006-2849
Phone
(602) 839-3927
Fax
(602) 839-4233
NPI assigned
Apr 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 72155 AZ Primary

Addresses

Primary practice location

1300 N 12TH St Ste 508
Phoenix, AZ 85006-2849

Mailing address

1300 N 12TH St Ste 508
Phoenix, AZ 85006-2849

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
I20240625003973 AZ Practitioner - Internal Medicine 7719388768 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Loyola University of Chicago, Stritch School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner - University Hospital Based Physicians LLCGroup PAC ID 1052614294, 343 clinicians

Practice addresses (Care Compare)

1111 E McDowell Rd
Phoenix, AZ 85006-2612
Phone (602) 839-2000

Hospital & facility affiliations

  • Banner - University Medical Center Phoenix Hospital, Phoenix, AZ, CCN 030002

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72155AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner - University Hospital Based Physicians LLC CurrentSince Jun 1, 2024 Accepting new patients
Banner - University Hospital Based Physicians LLC CurrentSince Jun 1, 2024 Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Jun 1, 2024 Accepting new patients
Banner Hospital Based Physicians Arizona LLC Current Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Jun 1, 2024 Accepting new patients
Banner Cancer Center Specialists LLC CurrentSince Jun 1, 2024 Accepting new patients
Banner -- University Primary Care Physicians LLC CurrentSince Jun 1, 2024 Accepting new patients
Banner Cancer Center Specialists LLC CurrentSince Jun 1, 2024 Accepting new patients
Banner - University Medical Center Phoenix Past Accepting new patients

Locations

2946 E Banner Gateway Dr
Gilbert, AZ 85234
Phone (480) 256-5450

2946 E Banner Gateway Dr
Rm 2008
Gilbert, AZ 85234
Phone (480) 256-4523

1900 N Higley Rd
Gilbert, AZ 85234
Phone (480) 543-2000

1300 N 12th St
Ste 500
Phoenix, AZ 85006
Phone (602) 839-2606

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

1300 N 12th St
Ste 508
Phoenix, AZ 85006
Phone (602) 839-3927

Organizations & group practices 9

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 1

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": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1497334692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N 12TH ST STE 508",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N 12TH ST STE 508",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062849",
            "telephone_number": "602-839-3927",
            "fax_number": "602-839-4233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFMEISTER",
        "first_name": "CAROLYN",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-05",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "72155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.