Individual provider Active NPI

Morgan Fullmer Mathie, D.O.

  • Anesthesiology Physician
  • Tempe, AZ
National Provider Identifier
1578874863
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
006380 Issued in AZ
Practice address
2421 E Southern Ave
Ste 7
Tempe, AZ 85282-7612
Phone
(602) 262-8900
Fax
(602) 262-8890
NPI assigned
Jul 1, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 006380 AZ Primary

Addresses

Primary practice location

2421 E Southern Ave
Ste 7
Tempe, AZ 85282-7612

Mailing address

PO Box 41150
Mesa, AZ 85274-1150
Phone (480) 425-2162

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
I20140714002446 AZ Practitioner - Anesthesiology 4486888922 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Partners of Arizona LLCGroup PAC ID 8628317179, 85 clinicians

Practice addresses (Care Compare)

4605 E Elwood St
Suite 500
Phoenix, AZ 85040-1978
Phone (602) 200-9021

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Secure Anesthesia PLLC CurrentSince Sep 1, 2020 Accepting new patients
Anesthesia Partners of Arizona LLC Anesthesiology CurrentSince May 1, 2021 Accepting new patients
Valley Anesthesiology Consultants, Inc. Anesthesiology CurrentSince Jul 1, 2014 Accepting new patients

Locations

501 N Switzer Canyon Dr
Flagstaff, AZ 86001
Phone (928) 440-4610

18301 N 79th Ave
Ste E150
Glendale, AZ 85308
Phone (480) 684-7962

5555 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 588-5555

1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000

1500 S Dobson Rd
Ste 101
Mesa, AZ 85202
Phone (480) 306-6098

645 E Missouri Ave
Ste 300
Phoenix, AZ 85012
Phone (602) 262-8917

1850 N Central Ave
Ste 1600
Phoenix, AZ 85004
Phone (602) 744-4760

19829 N 27th Ave
Phoenix, AZ 85027
Phone (602) 879-5720

4605 E Elwood St
Ste 500
Phoenix, AZ 85040
Phone (469) 998-7443

2421 E Southern Ave
Ste 7
Tempe, AZ 85282
Phone (480) 832-3600

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.

NPI Registry JSON

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

{
    "created_epoch": "1277942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1578874863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41150",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852741150",
            "telephone_number": "480-425-2162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2421 E SOUTHERN AVE",
            "address_2": "STE 7",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827612",
            "telephone_number": "602-262-8900",
            "fax_number": "602-262-8890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIE",
        "first_name": "MORGAN",
        "middle_name": "FULLMER",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-01",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "006380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

Verify at the official NPI Registry.