Pravin U Dugel

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

22210 Issued in AZ

Practice address

1101 E Missouri Ave
Phoenix, AZ 85014-2709

Phone

(602) 222-2221

Fax

(602) 266-2044

NPI assigned

Aug 10, 2005

Last updated

May 21, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Eyenet Triage, PLC

  • Ophthalmology Physician
  • Phoenix, AZ
  • NPI 1932553211
  NPD (past) Authorized official

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590019200000",
    "number": "1780686766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32530",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850642530",
            "telephone_number": "602-265-2695",
            "fax_number": "602-265-5077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 E MISSOURI AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142709",
            "telephone_number": "602-222-2221",
            "fax_number": "602-266-2044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUGEL",
        "first_name": "PRAVIN",
        "middle_name": "U",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AZ",
            "license": "22210",
            "primary": true
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "AZ",
            "license": "22210",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159865",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John P Duffy, CCP
• Michael Duffy
• Rebecca Ann Duffy, LAC
• Sarah Duffy
• Marissa Dugan-Bingham, MSN, NP-C
• Richa Duggal, M.D.
• Heidi Dugi, MD
• Paige Ashley Dugi, BS, RBT
• Bernadette Danielle Duguay, LCSW
• Alexander Dugum, DO

• Ophthalmology Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Ophthalmology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2020; 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.