Individual provider Active NPI

Nema Senol Runyan, M.D.

  • Internal Medicine Physician
  • Mesa, AZ
National Provider Identifier
1619953171
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
56649 Issued in AZ
Practice address
2310 E Brown Rd
Mesa, AZ 85213-5226
Phone
(480) 649-9000
NPI assigned
Dec 16, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME79973 FL
Internal Medicine Physician 207R00000X 56649 AZ Primary

Addresses

Primary practice location

2310 E Brown Rd
Mesa, AZ 85213-5226

Mailing address

2310 E Brown Rd
Mesa, AZ 85213-5226
Phone (480) 649-9000

Other practice location 1

9124 E Main St Ste 20-21
Mesa, AZ 85207-8700
Phone (480) 295-8070

Other practice location 2

6499 38th Ave N
Suite C-1
St Petersburg, FL 33710
Phone (727) 345-3908

Other identifiers 1

IdentifierTypeStateIssuer
263394900MedicaidFL

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
I20180831001736 AZ Practitioner - Internal Medicine 3678510575 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brown Road Family Medicine, PLLCGroup PAC ID 5395781769, 6 clinicians

Practice addresses (Care Compare)

2310 E Brown Rd
Mesa, AZ 85213-5226
Phone (480) 649-9000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56649AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brown Road Family Medicine, PLLC CurrentSince Jun 1, 2024 Accepting new patients
Iora Health Massachusetts, P.C. Internal Medicine Past Accepting new patients
Banner-University Medical Group Family Medicine Past Accepting new patients
Iora Health, LLC Internal Medicine Past Accepting new patients
Keith Runyan, MD Past Accepting new patients

Locations

2310 E Brown Rd
Mesa, AZ 85213
Phone (480) 649-9000

Interoperability endpoints

  • Direct secure messaging: nema.runyan.p1@direct.brfmvmed.nextgenshare.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/CDACDD
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1619953171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 E BROWN RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852135226",
            "telephone_number": "480-649-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 E BROWN RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852135226",
            "telephone_number": "480-649-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9124 E Main St Ste 20-21",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852078700",
            "country_code": "US",
            "telephone_number": "480-295-8070",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6499 38th Ave N",
            "address_2": "Suite C-1",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "33710",
            "country_code": "US",
            "telephone_number": "727-345-3908",
            "fax_number": "727-345-4994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUNYAN",
        "first_name": "NEMA",
        "middle_name": "SENOL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-16",
        "last_updated": "2024-05-20",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME79973",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "56649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263394900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.