Individual provider Active NPI

Jena Haviland, DO

  • Surgery Physician
  • Luke AFB, AZ
National Provider Identifier
1518317213
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
008013 Issued in AZ
Practice address
7219 N Litchfield Rd
Luke AFB, AZ 85309-1529
Phone
(623) 856-9919
NPI assigned
Jun 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 008013 AZ Primary

Addresses

Primary practice location

7219 N Litchfield Rd
Luke AFB, AZ 85309-1529

Mailing address

7219 N Litchfield Rd
Luke AFB, AZ 85309-1529

Other names 1

  • Jena Bunda Former name

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
I20220707003048 AZ Practitioner - General Surgery 6800276858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6553 E Baywood Ave
Suite 101
Mesa, AZ 85206-1753
Phone (480) 543-6750

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.12 of 100Reported as group
Quality
76.35
Promoting interoperability
99
Improvement activities
40
Cost
71.55

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
008013AZMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Physician Specialists Arizona LLC Current Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Jun 22, 2022 Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Jun 22, 2022 Accepting new patients

Locations

1920 N Higley Rd
Ste 308
Gilbert, AZ 85234
Phone (480) 543-6600

1920 N Higley Rd
Ste 306
Gilbert, AZ 85234
Phone (480) 543-2606

6553 E Baywood Ave
Ste 101
Mesa, AZ 85206
Phone (480) 543-6750

6644 E Baywood Ave
Mesa, AZ 85206
Phone (480) 321-2000

120 E Main St
Ste A
Payson, AZ 85541
Phone (928) 474-9744

9165 W Thunderbird Rd
Ste 200
Peoria, AZ 85381
Phone (623) 285-1120

925 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-4498

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

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 2

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": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1518317213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7219 N LITCHFIELD RD",
            "city": "LUKE AFB",
            "state": "AZ",
            "postal_code": "853091529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7219 N LITCHFIELD RD",
            "city": "LUKE AFB",
            "state": "AZ",
            "postal_code": "853091529",
            "telephone_number": "623-856-9919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVILAND",
        "first_name": "JENA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-14",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "008013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENA",
            "last_name": "BUNDA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Luke AFB, AZ

Sources for this page

Verify at the official NPI Registry.