NPIMap

Individual provider Active NPI

Hao Kenith Fang, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Phoenix, AZ
National Provider Identifier
1871522524
Registry record updated Jan 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
28335 Issued in AZ
Practice address
3131 E Clarendon Ave
Suite 102
Phoenix, AZ 85016-7069
Phone
(602) 253-9168
Fax
(602) 251-3126
NPI assigned
Jul 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 28335 AZ Primary

Addresses

Primary practice location

3131 E Clarendon Ave
Suite 102
Phoenix, AZ 85016-7069

Mailing address

3131 E Clarendon Ave
Suite 102
Phoenix, AZ 85016-7069
Phone (602) 253-9168

Other identifiers 1

IdentifierTypeStateIssuer
507072MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040707000627 AZ Practitioner - Thoracic SurgeryPractitioner - General Surgery 2668459694 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Phoenix Cardiac Surgery PCGroup PAC ID 8426943036, 11 clinicians

Practice addresses (Care Compare)

1215 N Beaver St
Suite 203
Flagstaff, AZ 86001-3126
Phone (928) 773-2150

Hospital & facility affiliations

  • Banner - University Medical Center Phoenix Hospital, Phoenix, AZ, CCN 030002
  • Flagstaff Medical Center Hospital, Flagstaff, AZ, CCN 030023
  • Honorhealth Scottsdale Osborn Medical Center Hospital, Scottsdale, AZ, CCN 030038
  • Yuma Regional Medical Center Hospital, Yuma, AZ, CCN 030013

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion20
Coronary artery bypass graft (CABG)27
Pacemaker insertion or repair1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc CurrentSince Sep 7, 2013 Accepting new patients
Arizona Advanced Heart & Lung Specialists LLC Thoracic Surgery (Cardiothoracic Vascular Surgery) Current Accepting new patients
District Medical Group, Inc CurrentSince Sep 7, 2013 Accepting new patients
District Medical Group, Inc Current Accepting new patients
Phoenix Vein Institute PLLC PastSince Oct 1, 2006 Accepting new patients
District Medical Group, Inc Surgery Past Accepting new patients
Sjhmc Physician Services Past Accepting new patients
Banner - University Medical Center Phoenix Past Accepting new patients

Locations

8088 W Whitney Dr
Peoria, AZ 85345
Phone (602) 655-2000

2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

2525 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 344-1015

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

Organizations & group practices 9

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 7

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": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420588800000",
    "number": "1871522524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 E CLARENDON AVE",
            "address_2": "SUITE 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167069",
            "telephone_number": "602-253-9168",
            "fax_number": "602-251-3126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 E CLARENDON AVE",
            "address_2": "SUITE 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167069",
            "telephone_number": "602-253-9168",
            "fax_number": "602-251-3126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANG",
        "first_name": "HAO",
        "middle_name": "KENITH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2015-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "AZ",
            "license": "28335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "507072",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.