Individual provider Active NPI

Marc Alan Levison, MD

  • Trauma Surgery Physician
  • Phoenix, AZ
National Provider Identifier
1639268048
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
20572 Issued in AZ
Practice address
9327 N 3Rd St
Suite 200
Phoenix, AZ 85020-2470
Phone
(602) 870-2014
Fax
(602) 943-4808
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Trauma Surgery Physician 2086S0127X 20572 AZ Primary

Addresses

Primary practice location

9327 N 3Rd St
Suite 200
Phoenix, AZ 85020-2470

Mailing address

9626 E Adobe Dr
Scottsdale, AZ 85255-4401
Phone (480) 585-4961

Other identifiers 1

IdentifierTypeStateIssuer
068123MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20572AZMDTrauma Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1639268048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9626 E ADOBE DR",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852554401",
            "telephone_number": "480-585-4961",
            "fax_number": "602-943-4808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9327 N 3RD ST",
            "address_2": "SUITE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202470",
            "telephone_number": "602-870-2014",
            "fax_number": "602-943-4808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVISON",
        "first_name": "MARC",
        "middle_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "AZ",
            "license": "20572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "068123",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.