Individual provider Active NPI

Joseph C Woolley, DO

  • Pediatric Gastroenterology Physician
  • Phoenix, AZ
National Provider Identifier
1790162063
Registry record updated Jul 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
009592 Issued in AZ
Practice address
1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone
(602) 933-0940
Fax
(602) 933-2468
NPI assigned
May 6, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X 009592 AZ Primary

Addresses

Primary practice location

1919 E Thomas Rd
Phoenix, AZ 85016-7710

Mailing address

2108 E Thomas Rd Ste 130
Phoenix, AZ 85016-7761
Phone (602) 933-3124

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
I20220428002015 AZ Practitioner - Gastroenterology 1557667797 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Touro Un College of Osteopathic Medicine, Vallejo, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Children's HospitalGroup PAC ID 0446278584, 431 clinicians

Practice addresses (Care Compare)

1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone (602) 933-0930

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Arizona Healthcare Corporation Pediatrics CurrentSince Aug 5, 2022 Accepting new patients
Northern Arizona Healthcare Corporation CurrentSince Aug 5, 2022 Accepting new patients
Phoenix Children's Medical Group CurrentSince Apr 22, 2022 Accepting new patients
Phoenix Children's Hospital Pediatrics CurrentSince Apr 22, 2022 Accepting new patients

Locations

1665 N Avondale Blvd
Avondale, AZ 85392
Phone (602) 933-0005

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

1215 N Beaver St
Ste 203
Flagstaff, AZ 86001
Phone (928) 773-2249

6524 W Sack Dr
Ste 201
Glendale, AZ 85308
Phone (602) 933-0935

20325 N 51st Ave
Ste 116
Glendale, AZ 85308
Phone (602) 933-1010

5131 E Southern Ave
Mesa, AZ 85206
Phone (480) 833-5437

9319 E Cadence Pkwy
Mesa, AZ 85212
Phone (602) 933-3400

2108 E Thomas Rd
Ste 130
Phoenix, AZ 85016

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

2108 E Thomas Rd
Phoenix, AZ 85016

Interoperability endpoints

  • Direct secure messaging: jwoolley91618@direct.phhs.org

Organizations & group practices 4

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": "1430870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1790162063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 E THOMAS RD STE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167761",
            "telephone_number": "602-933-3124",
            "fax_number": "602-933-2468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-933-0940",
            "fax_number": "602-933-2468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOLLEY",
        "first_name": "JOSEPH",
        "middle_name": "C",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-06",
        "last_updated": "2022-07-08",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "AZ",
            "license": "009592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.