NPIMap

Organization Active NPI

Enticare PC

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Chandler, AZ
National Provider Identifier
1710014410
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X
License
4520 Issued in AZ
Legal business name
ENTICARE PC
Practice address
2051 W Chandler Blvd Ste 5
Chandler, AZ 85224-6239
Phone
(480) 214-9000
Fax
(480) 214-9999
NPI assigned
Feb 28, 2007
Last updated
Feb 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Authorized official

Name
Dr. Homan Mostafavi, D.O.NPI 1770679797
Title
Physicianowner
Phone
(480) 214-9000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X 4520 AZ Primary

Addresses

Primary practice location

2051 W Chandler Blvd Ste 5
Chandler, AZ 85224-6239

Mailing address

2051 W Chandler Blvd Ste 5
Chandler, AZ 85224-6239
Phone (480) 214-9000

Other identifiers 1

IdentifierTypeStateIssuer
4520OtherAZAZ LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070713000056 AZ Part B Supplier - Clinic/Group Practice 2264532779 Receives reassigned benefits from 31 practitioners
Practice locations: Scottsdale, AZ; San Tan Valley, AZ; Maricopa, AZ; Glendale, AZ; Gilbert, AZ; Chandler, AZ; Casa Grande, AZ

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

1968 N Peart Rd
Ste 20
Casa Grande, AZ 85122

2051 W Chandler Blvd
Ste 5
Chandler, AZ 85224
Phone (480) 672-2964

3367 S Mercy Rd
Ste 205A
Gilbert, AZ 85297

3420 S Mercy Rd
Ste 107
Gilbert, AZ 85297
Phone (480) 551-0300

17215 N 72nd Dr
Bldg D
Glendale, AZ 85308
Phone (858) 205-5486

17215 N 72nd Dr
Ste 140A
Glendale, AZ 85308

17215 N 72nd Dr
Ste DA104
Glendale, AZ 85308

19841 N 27th Ave
Ste 301
Phoenix, AZ 85027
Phone (623) 587-5449

7301 E 2nd St
Ste 308
Scottsdale, AZ 85251
Phone (480) 949-1212

Practitioners & affiliated clinicians

Practitioners 38

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707264000000",
    "number": "1710014410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 W CHANDLER BLVD STE 5",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852246239",
            "telephone_number": "480-214-9000",
            "fax_number": "480-214-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 W CHANDLER BLVD STE 5",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852246239",
            "telephone_number": "480-214-9000",
            "fax_number": "480-214-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENTICARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A",
        "authorized_official_last_name": "MOSTAFAVI",
        "authorized_official_first_name": "HOMAN",
        "authorized_official_title_or_position": "PHYSICIANOWNER",
        "authorized_official_telephone_number": "480-214-9000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "AZ",
            "license": "4520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ LICENSE",
            "identifier": "4520",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.