NPIMap

Individual provider Active NPI

Marc D Edwards, D.O.

  • Emergency Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1679750483
Registry record updated Jun 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
005625 Issued in AZ
Practice address
5102 W Campbell Ave
Maryvale Hospital Emergency Department
Phoenix, AZ 85031-1703
Phone
(623) 848-5204
NPI assigned
Jan 23, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OT011842 PA
Family Medicine Physician 207Q00000X OT011842 PA
Emergency Medicine Physician 207P00000X 005625 AZ Primary

Addresses

Primary practice location

5102 W Campbell Ave
Maryvale Hospital Emergency Department
Phoenix, AZ 85031-1703

Mailing address

5102 W Campbell Ave
Maryvale Hospital Emergency Department
Phoenix, AZ 85031-1703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110718000243 AZ Practitioner - Family PracticePractitioner - Emergency Medicine 2567630627 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Arizona College of Osteopathic Medicine Mid Western University, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tec Emergency Physicians of Arizona, LLCGroup PAC ID 6204256084, 155 clinicians

Practice addresses (Care Compare)

7171 S 51St Ave
Laveen, AZ 85339-2923
Phone (888) 732-3317

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
005625AZMDEmergency Medicine Physician
OT011842PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tec Emergency Physicians of Arizona, LLC CurrentSince Oct 12, 2020 Accepting new patients
Emergency Group of Arizona Professional Corporation Emergency Medicine CurrentSince Sep 9, 2017 Accepting new patients
District Medical Group, Inc Current Accepting new patients
Arizona Acute Medical Services 1 PC CurrentSince Oct 20, 2019 Accepting new patients
District Medical Group, Inc CurrentSince Mar 1, 2019 Accepting new patients
District Medical Group, Inc Emergency Medicine CurrentSince Mar 1, 2019 Accepting new patients

Locations

13677 W McDowell Rd
Goodyear, AZ 85395
Phone (623) 536-4200

7171 S 51st Ave
Laveen, AZ 85339
Phone (623) 584-5100

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

1930 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 532-1000

2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043

3929 E Bell Rd
Phoenix, AZ 85032
Phone (602) 923-5000

5102 W Campbell Ave
Phoenix, AZ 85031
Phone (623) 848-5000

1419 W Hunt Hwy
San Tan Vly, AZ 85143
Phone (480) 245-4300

5125 S Rural Rd
Tempe, AZ 85282
Phone (480) 306-8780

Organizations & group practices 6

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 12

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": "1201046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401840000000",
    "number": "1679750483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5102 W CAMPBELL AVE",
            "address_2": "MARYVALE HOSPITAL EMERGENCY DEPARTMENT",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850311703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5102 W CAMPBELL AVE",
            "address_2": "MARYVALE HOSPITAL EMERGENCY DEPARTMENT",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850311703",
            "telephone_number": "623-848-5204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "MARC",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-23",
        "last_updated": "2014-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OT011842",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OT011842",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "005625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.