Individual provider Active NPI

David Jacob Tramutolo

  • Sports Medicine (Family Medicine) Physician
  • Buckeye, AZ
National Provider Identifier
1912535782
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
011893 Issued in AZ
Practice address
21250 W Roosevelt St
Buckeye, AZ 85326-0312
Phone
(480) 420-0749
NPI assigned
Mar 29, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Sports Medicine (Family Medicine) Physician 207QS0010X 011893 AZ Primary

Addresses

Primary practice location

21250 W Roosevelt St
Buckeye, AZ 85326-0312

Mailing address

321 W Montebello Ave
Phoenix, AZ 85013-1846
Phone (602) 432-4213

Other practice location 1

13677 W McDowell Rd
Goodyear, AZ 85395-2635
Phone (602) 848-6512

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
I20250829003831 AZ Practitioner - Sports Medicine 1658773197 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
Arizona College of Osteopathic Medicine Mid Western University, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
VHS Outpatient Clinics IncGroup PAC ID 4486566726, 206 clinicians

Practice addresses (Care Compare)

21250 W Roosevelt St
Suite 306
Buckeye, AZ 85326-0315
Phone (602) 841-0741

5130 W Baseline Rd
Suite 102
Laveen, AZ 85339-2984
Phone (602) 237-0039

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
011893AZMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
VHS Outpatient Clinics, Inc. CurrentSince Aug 15, 2025 Accepting new patients
VHS Outpatient Clinics, Inc. CurrentSince Aug 15, 2025 Accepting new patients

Locations

21250 W Roosevelt St
Ste 306
Buckeye, AZ 85326
Phone (480) 420-0749

13677 W McDowell Rd
Goodyear, AZ 85395
Phone (623) 536-4200

5130 W Baseline Rd
Ste 102
Laveen, AZ 85339
Phone (602) 237-0039

Interoperability endpoints

  • Direct secure messaging: david.tramutolo.1@600.direct.athenahealth.com

Organizations & group practices 2

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": "1585440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1912535782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 W MONTEBELLO AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850131846",
            "telephone_number": "602-432-4213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21250 W ROOSEVELT ST",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853260312",
            "telephone_number": "480-420-0749"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13677 W McDowell Rd",
            "address_purpose": "LOCATION",
            "city": "Goodyear",
            "state": "AZ",
            "postal_code": "853952635",
            "country_code": "US",
            "telephone_number": "602-848-6512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAMUTOLO",
        "first_name": "DAVID",
        "middle_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-29",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "AZ",
            "license": "011893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buckeye, AZ

Sources for this page

Verify at the official NPI Registry.