NPIMap

Organization Active NPI

Deseret Family Medicine at Greenfield PLC

  • Primary Care Clinic/Center
  • Mesa, AZ
National Provider Identifier
1619620200
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
DESERET FAMILY MEDICINE AT GREENFIELD PLC
Practice address
7165 E University Dr Ste 141
Mesa, AZ 85207-6411
Phone
(480) 981-3000
Fax
(480) 924-6339
NPI assigned
Feb 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Authorized official

Name
Hugo Fazz, MDNPI 1588697031
Title
Owner
Phone
(480) 981-3000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

7165 E University Dr Ste 141
Mesa, AZ 85207-6411

Mailing address

7165 E University Dr Ste 141
Mesa, AZ 85207-6411
Phone (480) 981-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220324000291 AZ Part B Supplier - Clinic/Group Practice 5991190290 Receives reassigned benefits from 3 practitioners
Practice locations: Mesa, AZ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D0974107Deseret Family Medicine at Greenfield, PLC7165 E University Dr Ste 141, Mesa, AZ 85207Provider-performed microscopyMay 25, 2028

National Provider Directory

National Provider Directory

Locations

7165 E University Dr
Ste 141
Mesa, AZ 85207
Phone (480) 981-3000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EEEECD

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1643760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711584000000",
    "number": "1619620200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7165 E UNIVERSITY DR STE 141",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852076411",
            "telephone_number": "480-981-3000",
            "fax_number": "480-924-6339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7165 E UNIVERSITY DR STE 141",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852076411",
            "telephone_number": "480-981-3000",
            "fax_number": "480-924-6339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERET FAMILY MEDICINE AT GREENFIELD PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-02",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A",
        "authorized_official_last_name": "FAZZ",
        "authorized_official_first_name": "HUGO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-981-3000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.