Individual provider Active NPI

Diego G. Cardenas, M.D.

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1831153691
Registry record updated Oct 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19750 Issued in AZ
Practice address
8620 N 22ND Ave
200
Phoenix, AZ 85021-4251
Phone
(602) 674-6501
NPI assigned
Apr 17, 2006
Last updated
Oct 31, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 19750 AZ Primary

Addresses

Primary practice location

8620 N 22ND Ave
200
Phoenix, AZ 85021-4251

Mailing address

5130 W Baseline Rd
Ste 103
Laveen, AZ 85339-2984
Phone (602) 237-0039

Other identifiers 1

IdentifierTypeStateIssuer
469008MedicaidAZ

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
I20040804000534 AZ Practitioner - Family Practice 2860463767

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19750AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cigna Healthcare of Arizona, Inc. CurrentSince May 18, 2013 Accepting new patients
Cigna Healthcare of Arizona, Inc. CurrentSince May 18, 2013 Accepting new patients
Emergency Physicians Professional Association LTD Past Accepting new patients

Locations

4001 E Baseline Rd
Ste 107
Gilbert, AZ 85234
Phone (480) 532-4060

1840 S Stapley Dr
Ste 101
Mesa, AZ 85204
Phone (480) 464-8500

5735 E McKellips Rd
Ste 101
Mesa, AZ 85215
Phone (480) 718-6444

8888 E Raintree Dr
Fl 3
Scottsdale, AZ 85260

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320019200000",
    "number": "1831153691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5130 W BASELINE RD",
            "address_2": "STE 103",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853392984",
            "telephone_number": "602-237-0039",
            "fax_number": "602-237-7824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8620 N 22ND AVE",
            "address_2": "200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850214251",
            "telephone_number": "602-674-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDENAS",
        "first_name": "DIEGO",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2011-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "19750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "469008",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.