Individual provider Active NPI

Irene T Ma, MD

  • Plastic and Reconstructive Surgery Physician
  • Gilbert, AZ
National Provider Identifier
1770801870
Registry record updated Nov 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
A158679 Issued in CA
Practice address
2940 E. Banner Gateway Dr.
Suite 450
Gilbert, AZ 85234
Phone
(480) 256-6444
Fax
(480) 256-3682
NPI assigned
May 13, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MT210927 PA
Plastic and Reconstructive Surgery Physician 2086S0122X A158679 CA Primary

Addresses

Primary practice location

2940 E. Banner Gateway Dr.
Suite 450
Gilbert, AZ 85234

Mailing address

2940 E. Banner Gateway Dr.
Suite 450
Gilbert, AZ 85234
Phone (480) 256-6444

Other practice location 1

5779 E Mayo Blvd
Phoenix, AZ 85054-4502
Phone (480) 301-8000

Other practice location 2

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

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
I20200831001432 AZ Practitioner - Plastic and Reconstructive SurgeryPractitioner - Surgical Oncology 2668612243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: Surgical Oncology
Education
University of New Mexico School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner Cancer Center Specialists LLCGroup PAC ID 6103097779, 343 clinicians

Practice addresses (Care Compare)

2946 E Banner Gateway Dr
Gilbert, AZ 85234-2165
Phone (480) 256-6444

Hospital & facility affiliations

  • Banner Gateway Medical Center Hospital, Gilbert, AZ, CCN 030122
  • Banner Thunderbird Medical Center Hospital, Glendale, AZ, CCN 030089

Merit-based Incentive Payment System (MIPS)

Final score
78.42 of 100Reported as group
Quality
62.19
Promoting interoperability
99
Improvement activities
40
Cost
61.29

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A158679CAMDPlastic and Reconstructive Surgery Physician
MT210927PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Cancer Center Specialists LLC CurrentSince Sep 1, 2020 Accepting new patients
Banner Cancer Center Specialists LLC CurrentSince Sep 1, 2020 Accepting new patients

Locations

1900 N Higley Rd
Gilbert, AZ 85234
Phone (480) 543-2000

2940 E Banner Gateway Dr
Ste 450
Gilbert, AZ 85234
Phone (480) 256-3676

2946 E Banner Gateway Dr
Gilbert, AZ 85234
Phone (480) 256-5450

2946 E Banner Gateway Dr
Rm 2008
Gilbert, AZ 85234
Phone (480) 256-4523

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1273708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1770801870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2940 E. BANNER GATEWAY DR.",
            "address_2": "SUITE 450",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "85234",
            "telephone_number": "480-256-6444",
            "fax_number": "480-256-3682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 E. BANNER GATEWAY DR.",
            "address_2": "SUITE 450",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "85234",
            "telephone_number": "480-256-6444",
            "fax_number": "480-256-3682"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5779 E Mayo Blvd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850544502",
            "country_code": "US",
            "telephone_number": "480-301-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Pasteur Dr",
            "address_purpose": "LOCATION",
            "city": "Stanford",
            "state": "CA",
            "postal_code": "943052200",
            "country_code": "US",
            "telephone_number": "650-723-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MA",
        "first_name": "IRENE",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-13",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT210927",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "A158679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.