Individual provider Active NPI

Phillip E Richardson, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Glendale, AZ
National Provider Identifier
1629363072
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
041394 Issued in AZ
Practice address
7701 W Aspera Blvd
Glendale, AZ 85308-7947
Phone
(623) 248-2100
NPI assigned
Jun 14, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 041394 KY
Foot & Ankle Surgery Podiatrist 213ES0103X 07001258A IN
Foot & Ankle Surgery Podiatrist 213ES0103X 041394 AZ Primary

Addresses

Primary practice location

7701 W Aspera Blvd
Glendale, AZ 85308-7947

Mailing address

7701 W Aspera Blvd
Glendale, AZ 85308-7947
Phone (623) 248-2100

Other identifiers 2

IdentifierTypeStateIssuer
300004767MedicaidIN
041394MedicaidAZ

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150812006171 AZ Practitioner - Podiatry 3577789338 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BHSM Rehabilitation LLCGroup PAC ID 2062773138, shared by 27 NPIs, 450 clinicians

Practice addresses (Care Compare)

25101 N Lake Pleasant Pkwy
Peoria, AZ 85383-1386
Phone (602) 610-6866

7701 W Aspera Blvd
Stes 102 201 301
Glendale, AZ 85308-7935
Phone (623) 248-2100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.12 of 100Reported as group
Quality
76.35
Promoting interoperability
99
Improvement activities
40
Cost
71.55

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal of nail tissue43
Removal or shaving of skin growth31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041394AZMDFoot & Ankle Surgery Podiatrist
07001258AINMDFoot & Ankle Surgery Podiatrist
041394KYMDFoot & Ankle Surgery Podiatrist
0820AZMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Physician Specialists Arizona LLC CurrentSince Sep 1, 2021 Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Mar 17, 2024 Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Sep 1, 2021 Accepting new patients
Banner Primary Care Physicians Arizona LLC PastSince Mar 17, 2024 Accepting new patients

Locations

7701 W Aspera Blvd
#102
Glendale, AZ 85308

5601 W Eugie Ave
Ste 100
Glendale, AZ 85304
Phone (602) 865-4510

7701 W Aspera Blvd
#1
Glendale, AZ 85308

7701 W Aspera Blvd
Ste 102
Glendale, AZ 85308
Phone (623) 248-2100

7701 W Aspera Blvd
Glendale, AZ 85308
Phone (623) 248-2100

9165 W Thunderbird Rd
Ste 100
Peoria, AZ 85381
Phone (623) 523-6560

9165 W Thunderbird Rd
Peoria, AZ 85381
Phone (623) 285-1120

9165 W Thunderbird Rd
Ste 200
Peoria, AZ 85381
Phone (623) 285-1120

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

14416 W Meeker Blvd
Sun City West, AZ 85375
Phone (623) 583-5083

Interoperability endpoints

  • Direct secure messaging: prichardson192785@direct.deaconess.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1629363072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7701 W ASPERA BLVD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853087947",
            "telephone_number": "623-248-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7701 W ASPERA BLVD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853087947",
            "telephone_number": "623-248-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "PHILLIP",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-14",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "KY",
            "license": "041394",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IN",
            "license": "07001258A",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AZ",
            "license": "041394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300004767",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041394",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.