Individual provider Active NPI

Rosa Maria Banuelos, M.D.

  • Family Medicine Physician
  • Chandler, AZ
National Provider Identifier
1528020856
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20230 Issued in AZ
Practice address
3041 W. Queen Creek Rd.
Chandler, AZ 85286
Phone
(520) 796-2600
Fax
(602) 528-1255
NPI assigned
Apr 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20230 AZ Primary

Addresses

Primary practice location

3041 W. Queen Creek Rd.
Chandler, AZ 85286

Mailing address

PO Box 115
Sacaton, AZ 85147-0002
Phone (520) 796-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20080325000122 TX Practitioner - Family Practice 1052207362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arizona College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gila River Health Care CorporationGroup PAC ID 0648174185, 245 clinicians

Practice addresses (Care Compare)

3042 W Queen Creek Rd
Hu Hu Kam Memorial Hospital
Chandler, AZ 85286-0038
Phone (602) 528-1200

Hospital & facility affiliations

  • Huhu Kam Memorial Hospital Hospital, Sacaton, AZ, CCN 031308

Merit-based Incentive Payment System (MIPS)

Final score
89.21 of 100Reported as group
Quality
76.88
Promoting interoperability
76
Improvement activities
40
Cost
73.83

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gila River Health Care Corporation CurrentSince Nov 26, 2023 Accepting new patients
Gila River Health Care Corporation Current Accepting new patients
Gila River Health Care CurrentSince Nov 26, 2023 Accepting new patients
Your Family Physician PC Family Medicine PastSince Sep 6, 2006 Accepting new patients

Locations

17487 S Healthcare Dr
#H
Laveen, AZ 85339
Phone (520) 550-6000

48203 W Farrell Rd
#H
Maricopa, AZ 85139
Phone (520) 568-3881

Organizations & group practices 7

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": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1528020856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 115",
            "city": "SACATON",
            "state": "AZ",
            "postal_code": "851470002",
            "telephone_number": "520-796-2600",
            "fax_number": "602-528-1296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3041 W. QUEEN CREEK RD.",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "85286",
            "telephone_number": "520-796-2600",
            "fax_number": "602-528-1255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANUELOS",
        "first_name": "ROSA",
        "middle_name": "MARIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "20230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.