Individual provider Active NPI

David G Brachman, MD

  • Radiation Oncology Physician
  • Phoenix, AZ
National Provider Identifier
1720042914
Registry record updated Feb 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
23852 Issued in AZ
Practice address
350 W Thomas Rd
St Joes Rad/Onc Dept
Phoenix, AZ 85013-4409
Phone
(602) 406-3170
Fax
(602) 406-4146
NPI assigned
Apr 14, 2006
Last updated
Feb 11, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 23852 AZ Primary

Addresses

Primary practice location

350 W Thomas Rd
St Joes Rad/Onc Dept
Phoenix, AZ 85013-4409

Mailing address

PO Box 41700
Phoenix, AZ 85080-1700
Phone (602) 274-4484

Other identifiers 1

IdentifierTypeStateIssuer
342387OtherAZAHCCCS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23852AZMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Past Accepting new patients

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

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360540800000",
    "number": "1720042914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41700",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850801700",
            "telephone_number": "602-274-4484",
            "fax_number": "602-240-3539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W THOMAS RD",
            "address_2": "ST JOES RAD/ONC DEPT",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134409",
            "telephone_number": "602-406-3170",
            "fax_number": "602-406-4146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACHMAN",
        "first_name": "DAVID",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2013-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "AZ",
            "license": "23852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "342387",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Feb 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.