NPIMap

Organization Active NPI

Bradley L Newswander, DPM,PLC

  • Orthopaedic Foot and Ankle Surgery Physician
  • San Tan Valley, AZ
National Provider Identifier
1740488246
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Foot and Ankle Surgery PhysicianTaxonomy code 207XX0004X
Legal business name
BRADLEY L NEWSWANDER, DPM,PLC
Practice address
37200 N Gantzel Rd Ste 250
San Tan Valley, AZ 85140-7368
Phone
(480) 321-8267
Fax
(480) 840-3458
NPI assigned
Jul 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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

Authorized official

Name
Bradley L Newswander, DPMNPI 1740254036
Title
Owner
Phone
(480) 840-3457

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Foot and Ankle Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XX0004X Primary
Podiatric Clinic/Center 261QP1100X

Addresses

Primary practice location

37200 N Gantzel Rd Ste 250
San Tan Valley, AZ 85140-7368

Mailing address

37200 N Gantzel Rd Ste 250
San Tan Valley, AZ 85140-7368
Phone (480) 321-8267

Other practice location 1

5656 S Power Rd Ste 124
Gilbert, AZ 85295-8489
Phone (480) 840-3457

Other names 1

  • Impression Foot & Ankle Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040624001199 AZ Part B Supplier - Clinic/Group Practice 4082690771 Receives reassigned benefits from 5 practitioners
Practice locations: Queen Creek, AZ
O20100930056655 AZ DME Supplier - Physician - Podiatry 4082690771 Practice locations: San Tan Valley, AZ

National Provider Directory

National Provider Directory

Locations

5656 S Power Rd
Ste 124
Gilbert, AZ 85295
Phone (480) 840-3457

21321 E Ocotillo Rd
Ste 123
Queen Creek, AZ 85142

37200 N Gantzel Rd
Ste 250
San Tan Vly, AZ 85140
Phone (480) 321-8267

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592870400000",
    "number": "1740488246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37200 N GANTZEL RD STE 250",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851407368",
            "telephone_number": "480-321-8267",
            "fax_number": "480-840-3458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37200 N GANTZEL RD STE 250",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851407368",
            "telephone_number": "480-321-8267",
            "fax_number": "480-840-3458"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5656 S Power Rd Ste 124",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852958489",
            "country_code": "US",
            "telephone_number": "480-840-3457",
            "fax_number": "480-840-3458",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BRADLEY L NEWSWANDER, DPM,PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-05",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A",
        "authorized_official_last_name": "NEWSWANDER",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-840-3457",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "207XX0004X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Impression Foot & Ankle",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Tan Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; 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.