Dr Bereket a Guangul

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

Legal business name

DR BEREKET A GUANGUL

Practice address

18701 N 67TH Ave
Glendale, AZ 85308-7100

Phone

(623) 561-1000

NPI assigned

Jul 19, 2012

Organization subpart

No

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

Authorized official

Name

Bereket A Guangul, MDNPI 1700190964

Title

Sole Member

Phone

(480) 228-3133

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bereket Azeze Guangul, M.D.

  • Internal Medicine Physician
  • Glendale, AZ
  • NPI 1700190964
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1342656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657756800000",
    "number": "1871848341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19801 N 59TH AVE #11073",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85318",
            "telephone_number": "480-228-3133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18701 N 67TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853087100",
            "telephone_number": "623-561-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR BEREKET A GUANGUL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-19",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A",
        "authorized_official_last_name": "GUANGUL",
        "authorized_official_first_name": "BEREKET",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "480-228-3133",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "43772",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "605956",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin Dowling, LCSW
• Brent Downey, BA, BHT
• Michelle Downie, BCBA
• Nicole Downs, P,T.
• Dustin Doyle, DPM
• Dr Harshad Patel MD PC
• Dr. Farzin Allameh DDS PC
• Dr. Greg Ceyhan DDS, PLLC
• Dr. John Schrolucke, Optometrist
• Dr. Mark L. Jaffe

• Infectious Disease Physician in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Infectious Disease Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.