Individual provider Active NPI

Mary E Coon, MD

  • Emergency Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1740234558
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35082656C Issued in OH
Practice address
4212 N 16TH St
Phoenix, AZ 85016-5319
Phone
(602) 263-1200
Fax
(602) 263-1619
NPI assigned
May 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35082656C OH Primary

Addresses

Primary practice location

4212 N 16TH St
Phoenix, AZ 85016-5319

Mailing address

PO Box 95460
Cleveland, OH 44101-0033
Phone (602) 581-6076

Other identifiers 5

IdentifierTypeStateIssuer
000000316949OtherBCBS
P00294036OtherRR MEDICARE FAIRFIELD
2448051MedicaidOH
000000386935OtherOHBCBS FAIRFIELD
P00096090OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, GA, TX3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20040403000180 OH Practitioner - Emergency Medicine 5092708446 Reassigns benefits to 3 organizations
I20160822001120 GA Practitioner - Emergency Medicine 5092708446 Reassigns benefits to 2 organizations
I20230907003964 TX Practitioner - Emergency Medicine 5092708446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4212 N 16TH St
Phoenix, AZ 85016-5319
Phone (602) 263-1200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35082656COHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Emergency Associates, LLC Emergency Medicine CurrentSince Jul 15, 2016 Accepting new patients
Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm CurrentSince Aug 6, 2023 Accepting new patients
The Bortolazzo Group, LLC Emergency Medicine CurrentSince Dec 15, 2017 Accepting new patients
Ohio Emergency Professionals Inc Emergency Medicine CurrentSince Nov 27, 2017 Accepting new patients
Emergency Professional Services, Inc. Emergency Medicine CurrentSince Nov 27, 2017 Accepting new patients
Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm CurrentSince Aug 6, 2023 Accepting new patients
Miami Valley Emergency Specialists, LLC Emergency Medicine CurrentSince Apr 1, 2009 Accepting new patients
Miami Valley Hospital Past Accepting new patients
Fairfield Hospitalists Inc Past Accepting new patients

Locations

4212 N 16th St
Phoenix, AZ 85016
Phone (602) 248-4187

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

2400 Lakeview Dr
#150
Beavercreek, OH 45431

1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636

2400 Miami Valley Dr
Dayton, OH 45459
Phone (937) 208-8394

9000 N Main St
Englewood, OH 45415
Phone (937) 208-8394

630 Eaton Ave
Hamilton, OH 45013
Phone (513) 867-2000

4940 Cottonville Rd
Jamestown, OH 45335
Phone (937) 298-4417

300 Austin West Blvd
Miamisburg, OH 45342
Phone (937) 388-7911

18697 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-8000

1 Medical Center Dr
Middletown, OH 45005
Phone (513) 424-2111

3130 N County Road 25A
Troy, OH 45373
Phone (937) 440-4000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 9

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1740234558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95460",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441010033",
            "telephone_number": "602-581-6076",
            "fax_number": "602-263-1619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4212 N 16TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165319",
            "telephone_number": "602-263-1200",
            "fax_number": "602-263-1619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COON",
        "first_name": "MARY",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35082656C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000316949",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE FAIRFIELD",
            "identifier": "P00294036",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2448051",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FAIRFIELD",
            "identifier": "000000386935",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00096090",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.