Paul Brandon McMaster, DPM
Individual provider Active NPI Podiatrist · Peridot, AZ
NPI 1508916933 · NPPES record last updated Sep 24, 2018
Key facts
- NPI
- 1508916933
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Podiatrist 213E00000X
- License
- 0540 (AZ)
- Practice address
- San Carlos Apache Healthcare
103 Medicine Way
Peridot, AZ 85542 - Phone
- (928) 475-1330
- NPI assigned
- Jan 10, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 5
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Podiatry
- Education
- California School of Podiatric Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- San Carlos Apache Healthcare Corporation
Northern Cochise Community Hospital Inc
Practice addresses (Care Compare)
103 Medicine Way Rd
Peridot, AZ 85542-0787
Phone (928) 475-1400
901 W Rex Allen Dr
Willcox, AZ 85643-1009
Phone (520) 384-3541
P O Box
Suite 787
Peridot, AZ 85542-0787
PO Box
Suite 787
Peridot, AZ 85542-0787
Hospital & facility affiliations
- San Carlos Apache Healthcare Corporation
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
| Removal of nail tissue | 129 |
| Removal or shaving of skin growth | 20 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160924000161 | TX | Practitioner - Podiatry | 3274518881 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Carlos Apache Healthcare Corporation | Current |
Accepting new patients | |
| San Carlos Apache Healthcare Corporation | Current |
Accepting new patients |
Locations
103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200
Interoperability endpoints
- pmcmaster@ncch.ssdirect.aprima.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 0540 | AZ | Yes |
Addresses
Primary practice location
San Carlos Apache Healthcare
103 Medicine Way
Peridot, AZ 85542
Mailing address
San Carlos Apache Healthcare
103 Medicine Way
Peridot, AZ 85542
Phone (928) 475-1330
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 612285-001 | Medicaid | AZ |
Other providers in Peridot, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 24, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.