Individual provider Active NPI

Neal Russell Hartman, M.D.

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Phoenix, AZ
National Provider Identifier
1508125295
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
60758 Issued in AZ
Practice address
1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone
(602) 933-1900
Fax
(602) 933-1918
NPI assigned
May 15, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X 2015030821 MO
Pediatrics Physician 208000000X 2015030821 MO
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 60758 AZ Primary

Addresses

Primary practice location

1919 E Thomas Rd
Phoenix, AZ 85016-7710

Mailing address

3200 E Camelback Rd Ste 250
Phoenix, AZ 85018-2327
Phone (602) 933-1814

Other practice location 1

1465 S Grand Blvd
St. Louis, MO 63104-1003
Phone (314) 577-5360

Other identifiers 1

IdentifierTypeStateIssuer
006541MedicaidAZ

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
I20200513000767 AZ Practitioner - Emergency Medicine 3375847783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Saint Louis University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Children'S HospitalGroup PAC ID 0446278584, 431 clinicians

Practice addresses (Care Compare)

1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone (602) 933-0930

Hospital & facility affiliations

  • Phoenix Children'S Hospital Hospital, Phoenix, AZ, CCN 033302

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2015030821MOMDPediatrics Physician
60758AZMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Children'S Medical Group CurrentSince Jun 1, 2020 Accepting new patients
Phoenix Children'S Medical Group CurrentSince Jun 1, 2020 Accepting new patients
Phoenix Children'S Hospital Pediatrics Current Accepting new patients

Locations

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

20325 N 51st Ave
Ste 116
Glendale, AZ 85308
Phone (602) 933-1010

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

9319 E Cadence Pkwy
Mesa, AZ 85212
Phone (602) 933-3400

5131 E Southern Ave
Mesa, AZ 85206
Phone (480) 833-5437

3200 E Camelback Rd
Ste 250
Phoenix, AZ 85018
Phone (602) 933-1814

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

6990 E Shea Blvd
Ste 104
Scottsdale, AZ 85254

Organizations & group practices 3

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": "1337040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1508125295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 E CAMELBACK RD STE 250",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182327",
            "telephone_number": "602-933-1814",
            "fax_number": "602-933-8972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-933-1900",
            "fax_number": "602-933-1918"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1465 S Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "St. Louis",
            "state": "MO",
            "postal_code": "631041003",
            "country_code": "US",
            "telephone_number": "314-577-5360",
            "fax_number": "314-268-4116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARTMAN",
        "first_name": "NEAL",
        "middle_name": "RUSSELL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-15",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "MO",
            "license": "2015030821",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2015030821",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "AZ",
            "license": "60758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006541",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.