Active NPI
Desiree Ekundayo
- Anesthesiology Physician
- Phoenix, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 54470
- Practice address
- 1850 N Central Ave Ste 1600
Phoenix, AZ 85004-4633 - Phone
- (602) 262-8900
- Fax
- (602) 262-8890
- NPI assigned
- Apr 11, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 036132039 | IL | |
| Anesthesiology Physician | 207L00000X | 60202 | MN | |
| Anesthesiology Physician | 207L00000X | 54470 | AZ | Primary |
Addresses
Primary practice location
1850 N Central Ave Ste 1600
Phoenix, AZ 85004-4633
Mailing address
200 1St St SW
Rochester, MN 55905-0001
Other practice location 1
200 1st St SW
Rochester, MN 55905-0001
Phone (507) 284-2511
Other names 1
- Desiree Ekundayo
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170630001001 | AZ | Practitioner - Anesthesiology | 4587880406 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1500 S Dobson Rd
Suite 101
Mesa, AZ 85202-4722
Phone (480) 412-3577
5555 W Thunderbird Rd
Glendale, AZ 85306-4622
Phone (602) 865-5555
9201 W Thomas Rd
Phoenix, AZ 85037-3332
Phone (623) 327-5047
Hospital & facility affiliations
- Banner Thunderbird Medical Center
- Banner Estrella Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036132039 | IL | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley Anesthesiology Consultants, Inc. | Anesthesiology | Current | Accepting new patients |
Locations
5555 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 588-5555
1500 S Dobson Rd
Ste 101
Mesa, AZ 85202
Phone (480) 306-6098
1850 N Central Ave
Ste 100
Phoenix, AZ 85004
1850 N Central Ave
Ste 1600
Phoenix, AZ 85004
Phone (602) 744-4760
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Phoenix, AZ
- NPI 1285660704
Anesthesiology, AZ
Hospital & facility affiliations 2
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": "1270944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1700102191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 1ST ST SW",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559050001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1850 N CENTRAL AVE STE 1600",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850044633",
"telephone_number": "602-262-8900",
"fax_number": "602-262-8890"
}
],
"practiceLocations": [
{
"address_1": "200 1st St SW",
"address_purpose": "LOCATION",
"city": "Rochester",
"state": "MN",
"postal_code": "559050001",
"country_code": "US",
"telephone_number": "507-284-2511",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EKUNDAYO",
"first_name": "DESIREE",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-11",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IL",
"license": "036132039",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MN",
"license": "60202",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "AZ",
"license": "54470",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DESIREE",
"last_name": "EKUNDAYO",
"code": "5",
"type": "Other Name"
}
]
}
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 Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.