Active NPI
Ross Bender, PTA
- Physical Therapy Assistant
- Glendale, AZ
National Provider Identifier
1558774356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- Practice address
- 17100 N 67TH Ave
Building 100
Glendale, AZ 85308-3605 - Phone
- (623) 979-2747
- NPI assigned
- Jun 9, 2014
- Last updated
- Jun 9, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | NU | Primary |
Addresses
Primary practice location
17100 N 67TH Ave
Building 100
Glendale, AZ 85308-3605
Mailing address
5401 E Van Buren St Unit 3017
Phoenix, AZ 85008-3466
Phone (402) 981-7190
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10118A | Other | AZ | PTA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aris Health Corportation | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402272000000",
"number": "1558774356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5401 E VAN BUREN ST UNIT 3017",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850083466",
"telephone_number": "402-981-7190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17100 N 67TH AVE",
"address_2": "BUILDING 100",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853083605",
"telephone_number": "623-979-2747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENDER",
"first_name": "ROSS",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-09",
"last_updated": "2014-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTA",
"identifier": "10118A",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.