Individual provider Active NPI

Brent Anthony Feudale, M.D.

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Madera, CA
National Provider Identifier
1598025116
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
A135002 Issued in CA
Practice address
9300 Valley Childrens PL # FC06
Madera, CA 93636-8761
Phone
(559) 353-5803
NPI assigned
May 17, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X A135002 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X NY
Pediatrics Physician 208000000X A135002 CA
Pediatrics Physician 208000000X 51747 AZ
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 51747 AZ

Addresses

Primary practice location

9300 Valley Childrens PL # FC06
Madera, CA 93636-8761

Mailing address

9300 Valley Childrens PL # SC05
Madera, CA 93636-8761

Other practice location 1

1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone (602) 933-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150624000873 CA Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 5698086106 Reassigns benefits to 1 organization
I20160914002569 AZ Practitioner - Pediatric Medicine 5698086106 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Emergency Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Childrens Medical GroupGroup PAC ID 9032439336, 50 clinicians

Practice addresses (Care Compare)

1524 McHenry Ave
Modesto, CA 95350-4500
Phone (209) 572-3880

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51747AZMDPediatric Emergency Medicine (Pediatrics) Physician
A135002CAMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc CurrentSince Nov 15, 2020 Accepting new patients
Phoenix Children's Hospital Pediatrics CurrentSince Sep 1, 2016 Accepting new patients
Ies Arizona PLLC CurrentSince Sep 1, 2024 Accepting new patients
North Valley Emergency Specialists CurrentSince Aug 1, 2019 Accepting new patients
Phoenix Children's Medical Group CurrentSince Sep 1, 2016 Accepting new patients
District Medical Group, Inc CurrentSince Nov 15, 2020 Accepting new patients
Valley Children's Medical Group Pediatrics CurrentSince Jun 2, 2023 Accepting new patients
District Medical Group, Inc Current Accepting new patients

Locations

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

5131 E Southern Ave
Mesa, AZ 85206
Phone (480) 833-5437

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

3200 E Camelback Rd
Ste 250
Phoenix, AZ 85018
Phone (602) 933-1814

5301 E Grant Rd
Tucson, AZ 85712
Phone (520) 324-1344

9300 Valley Childrens Pl
#5
Madera, CA 93636
Phone (559) 353-5700

9300 Valley Childrens Pl
Madera, CA 93636
Phone (559) 353-5700

9300 Valley Childrens Pl
#6
Madera, CA 93636
Phone (559) 353-5803

1524 McHenry Ave
Ste 550570
Modesto, CA 95350
Phone (209) 572-3880

Interoperability endpoints

  • Direct secure messaging: bfeudale125669@direct.valleywisehealth.org
  • Direct secure messaging: bfeudale65324@valleychildrens-prd.direct-ci.com

Organizations & group practices 8

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": "1337212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1598025116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 VALLEY CHILDRENS PL # SC05",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936368761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 VALLEY CHILDRENS PL # FC06",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936368761",
            "telephone_number": "559-353-5803"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1919 E Thomas Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850167710",
            "country_code": "US",
            "telephone_number": "602-933-1900",
            "fax_number": "602-933-1918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEUDALE",
        "first_name": "BRENT",
        "middle_name": "ANTHONY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-17",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "CA",
            "license": "A135002",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A135002",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "51747",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "AZ",
            "license": "51747",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madera, CA

Sources for this page

Verify at the official NPI Registry.