Active NPI
Brent Anthony Feudale, M.D.
- Pediatric Emergency Medicine (Pediatrics) Physician
- Madera, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Emergency Medicine (Pediatrics) Physician
- License
- A135002
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
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
| License | State | Type | Specialty |
|---|---|---|---|
| 51747 | AZ | MD | Pediatric Emergency Medicine (Pediatrics) Physician |
| A135002 | CA | MD | Pediatric Emergency Medicine (Pediatrics) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| District Medical Group, Inc | Current | Accepting new patients | |
| Phoenix Children's Hospital | Pediatrics | Current | Accepting new patients |
| Ies Arizona PLLC | Current | Accepting new patients | |
| North Valley Emergency Specialists | Current | Accepting new patients | |
| Phoenix Children's Medical Group | Current | Accepting new patients | |
| District Medical Group, Inc | Current | Accepting new patients | |
| Valley Children's Medical Group | Pediatrics | Current | 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
- bfeudale125669@direct.valleywisehealth.org
- 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.
-
- Pediatrics Physician
- Modesto, CA
- NPI 1437555265
-
- Anatomic Pathology & Clinical Pathology Physician
- Phoenix, AZ
- NPI 1336472448
-
- Emergency Medicine Physician
- Tucson, AZ
- NPI 1821752213
-
- Emergency Medicine Physician
- Glendale, AZ
- NPI 1285655209
-
dba Phoenix Children's Medical Group
- Pediatrics Physician
- Phoenix, AZ
- NPI 1922112044
-
- Emergency Medicine Physician
- Phoenix, AZ
- NPI 1144624339
-
- Dermatology Physician
- Phoenix, AZ
- NPI 1972836088
-
- Multi-Specialty Clinic/Center
- Mesa, AZ
- NPI 1487814240
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.