Individual provider Active NPI

Matthew Schmidgall, MD

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1912361387
Registry record updated Apr 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5555555 Issued in AZ
Practice address
1300 N 12TH St
Suite 605
Phoenix, AZ 85006-2848
Phone
(602) 839-4567
NPI assigned
Apr 11, 2016
Last updated
Apr 11, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2016

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 5555555 AZ Primary

Addresses

Primary practice location

1300 N 12TH St
Suite 605
Phoenix, AZ 85006-2848

Mailing address

1300 N 12TH St
Suite 605
Phoenix, AZ 85006-2848

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
I20190607001666 AZ Practitioner - Family Practice 0941570121 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arizona College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Banner - University Primary Care Physicians LLCGroup PAC ID 2365746450, 45 clinicians

Practice addresses (Care Compare)

1300 N 12TH St
Suite 500
Phoenix, AZ 85006-2849
Phone (602) 839-4567

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5555555AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner -- University Primary Care Physicians LLC CurrentSince Jul 1, 2019 Accepting new patients

Locations

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

1300 N 12th St
Ste 500
Phoenix, AZ 85006
Phone (602) 839-2606

1300 N 12th St
Ste 605
Phoenix, AZ 85006
Phone (602) 239-4567

1300 N 12th St
Ste 605608
Phoenix, AZ 85006
Phone (602) 839-4567

1300 N 12th St
Ste 608
Phoenix, AZ 85006
Phone (602) 254-5321

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460332800000",
    "number": "1912361387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N 12TH ST",
            "address_2": "SUITE 605",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N 12TH ST",
            "address_2": "SUITE 605",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062848",
            "telephone_number": "602-839-4567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDGALL",
        "first_name": "MATTHEW",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-11",
        "last_updated": "2016-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "5555555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.