Phoenix Plastic Surgery, PLLC

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

Legal business name

PHOENIX PLASTIC SURGERY, PLLC

Practice address

9250 N 3Rd St Ste 1003
Phoenix, AZ 85020-2402

Phone

(602) 331-7811

Fax

(833) 807-8800

NPI assigned

May 2, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Roni B Prucz, MDNPI 1386886943

Title

Managing Partner

Phone

(480) 625-0003

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Practitioners 1

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

• Roni Benjamin Prucz, MD

  • Plastic Surgery Physician
  • Phoenix, AZ
  • NPI 1386886943

  Plastic and Reconstructive Surgery

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1556755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556755200000",
    "number": "1508421819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7575 E REDFIELD RD STE 235",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603929",
            "telephone_number": "304-685-9808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9250 N 3RD ST STE 1003",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202402",
            "telephone_number": "602-331-7811",
            "fax_number": "833-807-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX PLASTIC SURGERY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-02",
        "last_updated": "2019-05-02",
        "status": "A",
        "authorized_official_last_name": "PRUCZ",
        "authorized_official_first_name": "RONI",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "480-625-0003",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Plastic and Reconstructive Surgery Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Plastic and Reconstructive Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.