Individual provider Active NPI

Christa Marie McEnerney, D.O.

  • Family Medicine Physician
  • Boston, MA
National Provider Identifier
1831536788
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
6883 Issued in AZ
Practice address
75 State St FL 26
Boston, MA 02109-1827
Phone
(855) 635-1393
NPI assigned
Jun 2, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2023

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 6883 AZ Primary

Addresses

Primary practice location

75 State St FL 26
Boston, MA 02109-1827

Mailing address

7214 W Tether TRL
Peoria, AZ 85383-7341
Phone (515) 864-6562

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20141029001867 IA Practitioner - Family Practice 9931322039 Reassigns benefits to 1 organization
I20160627002605 AZ Practitioner - Family Practice 9931322039 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6883AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Honorhealth Medical Group, LLC CurrentSince Jun 1, 2016 Accepting new patients
Honorhealth Ambulatory Current Accepting new patients
Honorhealth Ambulatory CurrentSince Jun 1, 2016 Accepting new patients
Honorhealth Medical Group, LLC Current Accepting new patients
Broadlawns Medical Center CurrentSince Sep 20, 2014 Accepting new patients
Scottsdale Healthcare Corporation Family Medicine CurrentSince Jun 1, 2016 Accepting new patients
Squaw Peak Family Physicians PC Family Medicine Current Accepting new patients
Honorhealth Medical Group, LLC Family Medicine CurrentSince Jun 1, 2016 Accepting new patients
Honorhealth Medical Group, LLC Family Medicine Current Accepting new patients
Broadlawns Medical Center CurrentSince Sep 20, 2014 Accepting new patients

Locations

3648 W Anthem Way
Ste A100
Anthem, AZ 85086
Phone (623) 434-6444

4712 E Dynamite Blvd
Cave Creek, AZ 85331
Phone (480) 342-8711

6220 W Bell Rd
Ste 130
Glendale, AZ 85308
Phone (602) 547-7348

1610 W Glendale Ave
#128
Phoenix, AZ 85021
Phone (623) 780-1999

2500 W Utopia Rd
Ste 100
Phoenix, AZ 85027
Phone (623) 683-4462

4131 N 24th St
Ste B102
Phoenix, AZ 85016
Phone (602) 955-6632

18404 N Tatum Blvd
Ste 101
Phoenix, AZ 85032
Phone (602) 992-1900

34975 N North Valley Pkwy
Ste 100
Phoenix, AZ 85086
Phone (623) 295-4820

9327 N 3rd St
Ste 100
Phoenix, AZ 85020
Phone (602) 371-3100

20745 N Scottsdale Rd
Scottsdale, AZ 85255
Phone (480) 419-8572

10510 N 92nd St
Ste 200
Scottsdale, AZ 85258
Phone (480) 323-1250

1801 Hickman Rd
Des Moines, IA 50314
Phone (515) 282-2200

Organizations & group practices 10

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": "1370131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1831536788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7214 W TETHER TRL",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853837341",
            "telephone_number": "515-864-6562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 STATE ST FL 26",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021091827",
            "telephone_number": "855-635-1393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCENERNEY",
        "first_name": "CHRISTA",
        "middle_name": "MARIE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-02",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "6883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.