Breeane Wazney, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

65765 Issued in AZ

Practice address

21772 S Ellsworth Loop Rd
Queen Creek, AZ 85142-7709

Phone

(480) 512-3700

Fax

(480) 512-3715

NPI assigned

Apr 22, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Banner Childrens Banner Health Clinic LLC

  • Primary Care Clinic/Center
  • Phoenix, AZ
  • NPI 1407191216
  Medicare reassignment NPD
• Banner Hospital Based Physicians Arizona LLC

  • Multi-Specialty Clinic/Center
  • San Tan Valley, AZ
  • NPI 1275889891
  Medicare reassignment NPD
• Banner Childrens Banner Health Clinic LLC

  • Primary Care Clinic/Center
  • Phoenix, AZ
  • NPI 1285278077
  NPD
• Banner Childrens Banner Health Clinic LLC

  • Primary Care Clinic/Center
  • Phoenix, AZ
  • NPI 1558606020
  NPD
• Banner Hospital Based Physicians Arizona LLC

  • Multi-Specialty Clinic/Center
  • Gilbert, AZ
  • NPI 1124374822
  NPD
• Banner Hospital Based Physicians Arizona LLC

  • Critical Care Medicine (Internal Medicine) Physician
  • Phoenix, AZ
  • NPI 1780445171
  NPD

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

{
    "created_epoch": "1555891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1538722822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17764 MILLSTONE DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480444185",
            "telephone_number": "586-610-1232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21772 S ELLSWORTH LOOP RD",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851427709",
            "telephone_number": "480-512-3700",
            "fax_number": "480-512-3715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAZNEY",
        "first_name": "BREEANE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-22",
        "last_updated": "2022-10-05",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "65765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon Wan, DO
• Tiffany Wangard, LACTATION CONSULTANT
• James Burt Ward, D.C.
• Terry Watson, AGACNP-BC
• Wayne a. Formica
• Jessica Webb
• Lisa Lashelle Webster
• Keith Weisgerber, CSFA
• Kariessa Taylor Welch, FNP-C
• West Combs Dental LLC (Ironwood Dental)

• Pediatrics Physician in Queen Creek, AZ
• Providers in Queen Creek, AZ by specialty
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.