Organization Active NPI

Susan Bazzell, MD, PLLC

  • Anesthesiology Physician
  • Mesa, AZ
National Provider Identifier
1669716783
Registry record updated Nov 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
27804 Issued in AZ
Legal business name
SUSAN BAZZELL, MD, PLLC
Practice address
4838 E Baseline Rd
Suite 108
Mesa, AZ 85206-4671
Phone
(480) 981-2400
Fax
(480) 981-2407
NPI assigned
Nov 15, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2012

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

Authorized official

Name
Susan K. Bazzell, M.D.
Title
Owner
Phone
(520) 288-5788

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X 27804 AZ Primary

Addresses

Primary practice location

4838 E Baseline Rd
Suite 108
Mesa, AZ 85206-4671

Mailing address

5151 E. Broadway
Suite 1600
Tucson, AZ 85711
Phone (520) 288-5788

Other identifiers 1

IdentifierTypeStateIssuer
531310MedicaidAZ

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352937600000",
    "number": "1669716783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5151 E. BROADWAY",
            "address_2": "SUITE 1600",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85711",
            "telephone_number": "520-288-5788",
            "fax_number": "480-981-2407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4838 E BASELINE RD",
            "address_2": "SUITE 108",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064671",
            "telephone_number": "480-981-2400",
            "fax_number": "480-981-2407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN BAZZELL, MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A",
        "authorized_official_last_name": "BAZZELL",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-288-5788",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "27804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "531310",
            "state": "AZ"
        }
    ],
    "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 Nov 15, 2012; 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.