NPIMap

Individual provider Active NPI

Justin Daniel Doroshenko, DO

  • Emergency Medicine Physician
  • Flagstaff, AZ
National Provider Identifier
1780326710
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
011679 Issued in AZ
Practice address
1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone
(928) 214-3930
NPI assigned
Apr 11, 2022
Last updated
Jan 7, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X V5523 TX
Emergency Medicine Physician 207P00000X 011679 AZ Primary

Addresses

Primary practice location

1200 N Beaver St
Flagstaff, AZ 86001-3118

Mailing address

PO Box 67
Flagstaff, AZ 86002-0067

Other practice location 1

2601 E Roosevelt St
Phoenix, AZ 85008-4973
Phone (602) 455-1015 ext. 05000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AZ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250204003494 TX Practitioner - Emergency Medicine 6800326901 Reassigns benefits to 3 organizations
I20250716002615 AZ Practitioner - Emergency Medicine 6800326901 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of New England, College of Osteo Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Flagstaff Emergency PhysiciansGroup PAC ID 2860380813, 43 clinicians
DHHS IHS Phoenix AreaGroup PAC ID 2668649567, 72 clinicians
District Medical Group IncGroup PAC ID 7315086691, 454 clinicians

Practice addresses (Care Compare)

1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 774-1693

200 W Hospital Dr
Whiteriver, AZ 85941-0860
Phone 92833849113532

2601 E Roosevelt St
Phoenix, AZ 85008-4973
Phone (602) 344-5011

PO Box
Suite 860
Whiteriver, AZ 85941-0860

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
V5523TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Flagstaff Emergency Physicians Emergency Medicine CurrentSince Jul 2, 2025 Accepting new patients
Concord Medical Group PLLC Emergency Medicine Current Accepting new patients
District Medical Group, Inc Emergency Medicine CurrentSince Jan 1, 2026 Accepting new patients
Concord Medical Group of Texas PLLC Emergency Medicine CurrentSince Jan 3, 2025 Accepting new patients
District Medical Group, Inc CurrentSince Jan 1, 2026 Accepting new patients
22250 Bulverde Cec Fossil Creek LLC Past Accepting new patients
2013 Broadway Emergency Care LLC Past Accepting new patients

Locations

269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

3700 W State Route 89A
Sedona, AZ 86336
Phone (928) 204-3000

200 S Geneva St
Breckenridge, TX 76424
Phone (254) 559-2241

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

3349 S Highway 181
Kenedy, TX 78119
Phone (830) 583-3401

Organizations & group practices 10

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.

Hospital & facility affiliations 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1649635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1780326710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860020067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N BEAVER ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013118",
            "telephone_number": "928-214-3930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2601 E Roosevelt St",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850084973",
            "country_code": "US",
            "telephone_number": "602-455-1015 x05000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOROSHENKO",
        "first_name": "JUSTIN",
        "middle_name": "DANIEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-11",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "V5523",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "011679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.