Individual provider Active NPI

Patrick G Fredenberg, MD

  • Diagnostic Radiology Physician
  • Glendale, AZ
National Provider Identifier
1710976766
Registry record updated Mar 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
26144 Issued in AZ
Practice address
5605 W Eugie Ave Ste 110
Glendale, AZ 85304-1273
Phone
(623) 847-2000
NPI assigned
Oct 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 26144 AZ Primary

Addresses

Primary practice location

5605 W Eugie Ave Ste 110
Glendale, AZ 85304-1273

Mailing address

2323 W Rose Garden LN
Phoenix, AZ 85027-2530
Phone (623) 931-7999

Other practice location 1

2323 W Rose Garden Ln
Phoenix, AZ 85027-2530
Phone (623) 931-7999

Other identifiers 1

IdentifierTypeStateIssuer
527228MedicaidAZ

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
I20040513000736 AZ Practitioner - Diagnostic Radiology 6002806908 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Arizona College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner Imaging Services LLCGroup PAC ID 1850724386, 122 clinicians
Associated Valley Radiologists, LTDGroup PAC ID 8325388499, 59 clinicians

Practice addresses (Care Compare)

10474 W Thunderbird Blvd
Suite 100
Sun City, AZ 85351-3015
Phone (480) 610-7400

1076 W Chandler Blvd
Suite 120
Chandler, AZ 85224-5224
Phone (480) 610-7400

1125 S Alma School Rd
Suite 110
Chandler, AZ 85286-2810
Phone (480) 610-7400

13555 W McDowell Rd
Suite 106
Goodyear, AZ 85395-2625
Phone (623) 847-2000

13640 N Plaza del Rio Blvd
Suite 105
Peoria, AZ 85381-4846
Phone (480) 610-7400

13909 W Camino del Sol
Suite 101
Sun City West, AZ 85375-1413
Phone (480) 610-7400

16641 N 40TH St
Suite 1
Phoenix, AZ 85032-3343
Phone (480) 610-7400

1800 N Civic SQ
Suite 120
Goodyear, AZ 85395-2390
Phone (480) 610-7400

18275 N 59TH Ave
Suite 168
Glendale, AZ 85308-1254
Phone (623) 847-2000

1828 E Florence Blvd
Suite 118 and 128
Casa Grande, AZ 85122-4783
Phone (480) 610-7400

1840 E Warner Rd
Suite 114
Tempe, AZ 85284-3445
Phone (480) 610-7400

5601 W Eugie Ave
Suite 102
Glendale, AZ 85304-1256
Phone (480) 610-7400

5605 W Eugie Ave
Suite 110
Glendale, AZ 85304-1273
Phone (480) 610-7400

6424 E Broadway Rd
Suite 101
Mesa, AZ 85206-1750
Phone (480) 610-7400

665 N Gilbert Rd
Suite 154
Gilbert, AZ 85234-3395
Phone (480) 610-7400

7701 W Aspera Blvd
Suite 101
Glendale, AZ 85308-7935
Phone (480) 610-7400

9305 W Thomas Rd
Suite 100 and 200
Phoenix, AZ 85037-3333
Phone (480) 610-7400

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Sep 1, 2012 Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Sep 1, 2012 Accepting new patients
Page Hospital Current Accepting new patients
Banner Imaging Services LLC CurrentSince Jan 1, 2020 Accepting new patients
Toca at Banner Health LLC CurrentSince Feb 10, 2021 Accepting new patients
Sonoran Radiology LTD Diagnostic Radiology CurrentSince Jul 24, 2020 Accepting new patients
Associated Valley Radiologists LTD Diagnostic Radiology CurrentSince Mar 1, 2019 Accepting new patients
Banner Imaging Services LLC Diagnostic Radiology Current Accepting new patients
Toca at Banner Health LLC CurrentSince Feb 10, 2021 Accepting new patients
Banner Hospital Based Physicians Arizona LLC Current Accepting new patients
Banner Imaging Services LLC Diagnostic Radiology CurrentSince Jan 1, 2020 Accepting new patients
Scottsdale Medical Imaging, LTD Diagnostic Radiology Past Accepting new patients

Locations (25 of 68)

3648 W Anthem Way
Ste A100
Anthem, AZ 85086
Phone (623) 434-6444

2050 W Southern Ave
Apache Junction, AZ 85120
Phone (480) 237-3200

1828 E Florence Blvd
Ste 118
Casa Grande, AZ 85122
Phone (520) 381-9729

1828 E Florence Blvd
Ste B118
Casa Grande, AZ 85122

1076 W Chandler Blvd
Ste 120
Chandler, AZ 85224
Phone (480) 821-9198

3645 S Rome St
Ste 101
Gilbert, AZ 85297

665 N Gilbert Rd
Ste 154
Gilbert, AZ 85234
Phone (480) 507-4500

5555 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 588-5555

5605 W Eugie Ave
Ste 110
Glendale, AZ 85304
Phone (602) 938-2002

7701 W Aspera Blvd
Ste 101
Glendale, AZ 85308
Phone (623) 248-2100

5601 W Eugie Ave
Ste 102
Glendale, AZ 85304
Phone (602) 588-3420

18275 N 59th Ave
Ste 168
Glendale, AZ 85308

5310 W Thunderbird Rd
Ste 100
Glendale, AZ 85306
Phone (602) 978-0892

5757 W Thunderbird Rd
Ste W100
Glendale, AZ 85306
Phone (623) 931-7999

6220 W Bell Rd
Ste 110
Glendale, AZ 85308
Phone (602) 547-7230

1800 N Civic Sq
Ste 120
Goodyear, AZ 85395
Phone (928) 813-4624

13555 W McDowell Rd
Ste 106
Goodyear, AZ 85395
Phone (623) 535-0917

6553 E Baywood Ave
Ste 102
Mesa, AZ 85206
Phone (480) 268-7600

1940 S Country Club Dr
Ste 101
Mesa, AZ 85210
Phone (480) 476-8800

6750 E Baywood Ave
Mesa, AZ 85206
Phone (480) 854-5000

1052 E McKellips Rd
Mesa, AZ 85203
Phone (480) 425-5080

6644 E Baywood Ave
Mesa, AZ 85206
Phone (480) 321-2000

1450 S Dobson Rd
Ste A100
Mesa, AZ 85202
Phone (480) 545-9779

1201 S Alma School Rd
Ste 14500
Mesa, AZ 85210
Phone (602) 698-7715

6424 E Broadway Rd
Ste 101
Mesa, AZ 85206
Phone (602) 830-0619

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551916800000",
    "number": "1710976766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 W ROSE GARDEN LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850272530",
            "telephone_number": "623-931-7999",
            "fax_number": "623-842-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5605 W EUGIE AVE STE 110",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853041273",
            "telephone_number": "623-847-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2323 W Rose Garden Ln",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850272530",
            "country_code": "US",
            "telephone_number": "623-931-7999",
            "fax_number": "623-842-5640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREDENBERG",
        "first_name": "PATRICK",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2019-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "26144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "527228",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.