Individual provider Active NPI

David A. Nyberg, MD

  • Diagnostic Radiology Physician
  • Gilbert, AZ
National Provider Identifier
1790752459
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
29769 Issued in AZ
Practice address
3499 S Mercy Rd
Gilbert, AZ 85297-0437
Phone
(480) 355-8525
Fax
(480) 355-3115
NPI assigned
Mar 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 29769 AZ Primary

Addresses

Primary practice location

3499 S Mercy Rd
Gilbert, AZ 85297-0437

Mailing address

1015 N Marcus LN
Spokane Valley, WA 99216-2374
Phone (509) 993-4370

Other identifiers 3

IdentifierTypeStateIssuer
29769OtherAZAZ LICENSE #
718249MedicaidAZ
MD00022894OtherWAWA LICENSE #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ultimate Male Current Accepting new patients
Womens Ultrasound Services, LLC Current Accepting new patients
Morning Star Obstetrics & Gynecology PC CurrentSince Jan 19, 2025 Accepting new patients
Seattle Nuclear Medicine-Ultrasound Associates Past Accepting new patients

Locations

3499 S Mercy Rd
Gilbert, AZ 85297
Phone (480) 355-8525

5111 N Scottsdale Rd
Ste 150
Scottsdale, AZ 85250
Phone (480) 970-1937

Interoperability endpoints

  • Direct secure messaging: david.nyberg.1@20219.direct.athenahealth.com

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": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1790752459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 N MARCUS LN",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992162374",
            "telephone_number": "509-993-4370",
            "fax_number": "480-781-4988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3499 S MERCY RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852970437",
            "telephone_number": "480-355-8525",
            "fax_number": "480-355-3115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYBERG",
        "first_name": "DAVID",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "29769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ LICENSE #",
            "identifier": "29769",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "718249",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA LICENSE #",
            "identifier": "MD00022894",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; 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.