Individual provider Active NPI

Douglas Milan Maready, M.D.

  • Internal Medicine Physician
  • Mesa, AZ
National Provider Identifier
1689876252
Registry record updated Jan 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
54000 Issued in AZ
Practice address
4135 S Power Rd Ste 113
Mesa, AZ 85212-3625
Phone
(480) 626-2444
Fax
(480) 409-2987
NPI assigned
Jun 5, 2007
Last updated
Jan 10, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 54000 AZ Primary

Addresses

Primary practice location

4135 S Power Rd Ste 113
Mesa, AZ 85212-3625

Mailing address

PO Box 88747
Milwaukee, WI 53288-8747
Phone (480) 945-6777

Other practice location 1

4455 E Camelback Rd Ste D155
Phoenix, AZ 85018-2888
Phone (480) 626-2444

Other identifiers 2

IdentifierTypeStateIssuer
331408MedicaidAZ
1689876252OtherNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090715000717 UT Practitioner - Internal Medicine 4082761598 Reassigns benefits to 1 organization
I20170913003951 AZ Practitioner - Internal Medicine 4082761598 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Tulane University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Forte - Phoenix PLLCGroup PAC ID 7618240797, 11 clinicians

Practice addresses (Care Compare)

4135 S Power Rd
Suite 113
Mesa, AZ 85212-3625
Phone (480) 626-2444

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54000AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Camelback Sports Therapy LLC CurrentSince Oct 2, 2017 Accepting new patients
Uintah Basin Medical Center CurrentSince Sep 9, 2019 Accepting new patients
Uintah Basin Medical Center CurrentSince Sep 9, 2019 Accepting new patients
Openloop Healthcare Partners PC PastSince Dec 11, 2020 Accepting new patients

Locations

4455 E Camelback Rd
Ste D155
Phoenix, AZ 85018
Phone (480) 626-2444

50 E 200 S
Duchesne, UT 84021
Phone (435) 738-2426

210 W 300 N
Roosevelt, UT 84066
Phone (435) 722-4691

210 W 300 N
#753
Roosevelt, UT 84066
Phone (435) 722-3971

250 W 300 N
#752
Roosevelt, UT 84066
Phone (435) 722-4691

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768003200000",
    "number": "1689876252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 88747",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532888747",
            "telephone_number": "480-945-6777",
            "fax_number": "480-257-7310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4135 S POWER RD STE 113",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852123625",
            "telephone_number": "480-626-2444",
            "fax_number": "480-409-2987"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4455 E Camelback Rd Ste D155",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850182888",
            "country_code": "US",
            "telephone_number": "480-626-2444",
            "fax_number": "480-409-2987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAREADY",
        "first_name": "DOUGLAS",
        "middle_name": "MILAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-05",
        "last_updated": "2026-01-10",
        "certification_date": "2026-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "54000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "331408",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1689876252",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.