Individual provider Active NPI

Diane Marie Shuck, MD

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1861477697
Registry record updated Mar 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
33158 Issued in AZ
Practice address
710 W Bell Rd
Phoenix, AZ 85023
Phone
(602) 588-3800
Fax
(602) 588-3764
NPI assigned
Dec 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2014

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 33158 AZ Primary

Addresses

Primary practice location

710 W Bell Rd
Phoenix, AZ 85023

Mailing address

25500 N. Norterra Parkway
BLDG. B
Phoenix, AZ 85085
Phone (602) 588-3800

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
I20050902000302 AZ Practitioner - Family Practice 9537191283 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33158AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Honorhealth Medical Group, LLC Family Medicine CurrentSince Oct 19, 2015 Accepting new patients
Honorhealth Medical Group, LLC Family Medicine CurrentSince Oct 19, 2015 Accepting new patients
Honorhealth Medical Group, LLC Current Accepting new patients
Squaw Peak Family Physicians PC Family Medicine Current Accepting new patients
Honorhealth Medical Group, LLC Family Medicine Current 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

6320 W Union Hills Dr
Ste 2300B
Glendale, AZ 85308
Phone (623) 561-9113

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

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

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

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

13991 W Grand Ave
Ste 105
Surprise, AZ 85374
Phone (623) 455-7800

Organizations & group practices 5

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": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395964800000",
    "number": "1861477697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25500 N. NORTERRA PARKWAY",
            "address_2": "BLDG. B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85085",
            "telephone_number": "602-588-3800",
            "fax_number": "602-588-3764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 W BELL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85023",
            "telephone_number": "602-588-3800",
            "fax_number": "602-588-3764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUCK",
        "first_name": "DIANE",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-14",
        "last_updated": "2014-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "33158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.