Individual provider Active NPI

Justin Michael Delange, D.O.

  • Neurology Physician
  • Flagstaff, AZ
National Provider Identifier
1689923096
Registry record updated Apr 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
006389 Issued in AZ
Practice address
1215 N Beaver St
Flagstaff, AZ 86001-3126
Phone
(928) 773-2200
Fax
(928) 773-2300
NPI assigned
Aug 30, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 56301 MN
Neurology Physician 2084N0400X 006389 AZ Primary

Addresses

Primary practice location

1215 N Beaver St
Flagstaff, AZ 86001-3126

Mailing address

1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 213-6235

Other identifiers 1

IdentifierTypeStateIssuer
927239MedicaidAZ

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141002002634 AZ Practitioner - Neurology 2466693676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Arizona College of Osteopathic Medicine Mid Western University, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northern Arizona Healthcare CorporationGroup PAC ID 3577473362, 391 clinicians

Practice addresses (Care Compare)

1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 779-3366

1215 N Beaver St
Suite 203
Flagstaff, AZ 86001-3126
Phone (928) 773-2249

2000 S Thompson St
Flagstaff, AZ 86001-8759
Phone (928) 226-6400

269 S Candy LN
Cottonwood, AZ 86326-4158
Phone (928) 639-6000

7810 N US Hwy 89
Flagstaff, AZ 86004-6255
Phone (928) 522-8375

Hospital & facility affiliations

  • Flagstaff Medical Center Hospital, Flagstaff, AZ, CCN 030023
  • Verde Valley Medical Center Hospital, Cottonwood, AZ, CCN 030007

Merit-based Incentive Payment System (MIPS)

Final score
82.13 of 100Reported as group
Quality
66.85
Promoting interoperability
99
Improvement activities
40
Cost
74.4

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
006389AZMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Arizona Healthcare Corporation CurrentSince Oct 10, 2018 Accepting new patients
Northern Arizona Healthcare Corporation Family Medicine CurrentSince Oct 10, 2018 Accepting new patients

Locations

269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251

7810 N US Highway 89
Flagstaff, AZ 86004
Phone (928) 522-8375

1215 N Beaver St
Flagstaff, AZ 86001
Phone (928) 773-2200

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235

107 E Oak Ave
Flagstaff, AZ 86001
Phone (928) 779-7880

1215 N Beaver St
Ste 203
Flagstaff, AZ 86001
Phone (928) 773-2249

107 E Oak Ave
Ste 101
Flagstaff, AZ 86001
Phone (928) 774-1811

Organizations & group practices 2

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 6

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": "1346284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1689923096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N BEAVER ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013118",
            "telephone_number": "928-213-6235",
            "fax_number": "928-213-6292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 N BEAVER ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013126",
            "telephone_number": "928-773-2200",
            "fax_number": "928-773-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELANGE",
        "first_name": "JUSTIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-30",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MN",
            "license": "56301",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AZ",
            "license": "006389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "927239",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.