Individual provider Active NPI

Edward H Charles, MD

  • Surgery Physician
  • Glendale, AZ
National Provider Identifier
1821097973
Registry record updated Aug 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
27117 Issued in AZ
Practice address
5757 W Thunderbird Rd
Suite E265
Glendale, AZ 85306-4641
Phone
(602) 843-8317
Fax
(602) 843-9091
NPI assigned
Jul 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 27117 AZ Primary

Addresses

Primary practice location

5757 W Thunderbird Rd
Suite E265
Glendale, AZ 85306-4641

Mailing address

2320 N 3Rd St
Phoenix, AZ 85004-1303
Phone (602) 258-9900

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
I20040601000205 AZ Practitioner - General Surgery 4284615618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Medical University of South Carolina College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner Physician Specialists Arizona LLCGroup PAC ID 6204002272, 371 clinicians

Practice addresses (Care Compare)

10401 W Thunderbird Blvd
Sun City, AZ 85351-3004
Phone (623) 832-4000

5555 W Thunderbird Rd
Banner Health Clinic
Glendale, AZ 85306-4622
Phone (602) 865-5555

7701 W Aspera Blvd
Stes 102 201 301
Glendale, AZ 85308-7935
Phone (623) 248-2100

9165 W Thunderbird Rd
Suite 200
Peoria, AZ 85381-4847
Phone (623) 285-1120

Hospital & facility affiliations

  • Banner Thunderbird Medical Center Hospital, Glendale, AZ, CCN 030089

Merit-based Incentive Payment System (MIPS)

Final score
84.12 of 100Reported as group
Quality
76.35
Promoting interoperability
99
Improvement activities
40
Cost
71.55

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)16
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27117AZMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Physician Specialists Arizona LLC CurrentSince Aug 1, 2015 Accepting new patients
Banner Physician Specialists Arizona LLC Current Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Aug 1, 2015 Accepting new patients
Banner Thunderbird Medical Center Past Accepting new patients

Locations

7701 W Aspera Blvd
Ste 102
Glendale, AZ 85308
Phone (623) 248-2100

5555 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 588-5555

7701 W Aspera Blvd
#1
Glendale, AZ 85308

9165 W Thunderbird Rd
Ste 200
Peoria, AZ 85381
Phone (623) 285-1120

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

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.

Hospital & facility affiliations 1

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": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438732800000",
    "number": "1821097973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 N 3RD ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041303",
            "telephone_number": "602-258-9900",
            "fax_number": "602-258-9904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5757 W THUNDERBIRD RD",
            "address_2": "SUITE E265",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064641",
            "telephone_number": "602-843-8317",
            "fax_number": "602-843-9091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "EDWARD",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2015-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "27117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.