Individual provider Active NPI

Adrienne B Pettit, D.O.

  • Internal Medicine Physician
  • Scottsdale, AZ
National Provider Identifier
1912993445
Registry record updated Aug 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
3860 Issued in AZ
Practice address
10900 N. Scottsdale Rd.
Suite 603
Scottsdale, AZ 85254-5216
Phone
(480) 607-3800
Fax
(480) 607-3808
NPI assigned
Sep 20, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 3860 AZ Primary

Addresses

Primary practice location

10900 N. Scottsdale Rd.
Suite 603
Scottsdale, AZ 85254-5216

Mailing address

10900 N. Scottsdale Rd.
Suite 603
Scottsdale, AZ 85254-5216
Phone (480) 607-3800

Other identifiers 1

IdentifierTypeStateIssuer
793069-02MedicaidAZ

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
I20031211000339 AZ Practitioner - HospitalistPractitioner - Internal Medicine 5496651929 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1111 E McDowell Rd
Phoenix, AZ 85006-2612
Phone (602) 839-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.53 of 100Reported as group
Quality
78.73
Promoting interoperability
98
Improvement activities
40
Cost
62.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3860AZMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Feb 1, 2017 Accepting new patients
Banner Hospital Based Physicians Arizona LLC Current Accepting new patients
Banner - University Hospital Based Physicians LLC CurrentSince Mar 1, 2017 Accepting new patients
Banner - University Hospital Based Physicians LLC CurrentSince Mar 1, 2017 Accepting new patients
Cogent Healthcare of Arizona PC Internal Medicine CurrentSince Aug 1, 2015 Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Feb 1, 2017 Accepting new patients

Locations

5555 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 588-5555

807 S Ponderosa St
Payson, AZ 85541
Phone (520) 474-3222

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

2000 W Bethany Home Rd
Phoenix, AZ 85015
Phone (480) 209-4000

2020 N Central Ave
Ste 1010
Phoenix, AZ 85004
Phone (602) 553-8400

16640 N 38th St
Phoenix, AZ 85032
Phone (602) 482-6671

9003 E Shea Blvd
Scottsdale, AZ 85260
Phone (480) 323-3383

7400 E Osborn Rd
Scottsdale, AZ 85251
Phone (480) 481-4000

300 El Camino Real
Sierra Vista, AZ 85635
Phone (520) 417-4594

5700 E Highway 90
Sierra Vista, AZ 85635
Phone (520) 263-2000

350 N Wilmot Rd
Tucson, AZ 85711
Phone (520) 873-3000

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

Organizations & group practices 6

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 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": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281052800000",
    "number": "1912993445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10900 N. SCOTTSDALE RD.",
            "address_2": "SUITE 603",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852545216",
            "telephone_number": "480-607-3800",
            "fax_number": "480-607-3808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10900 N. SCOTTSDALE RD.",
            "address_2": "SUITE 603",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852545216",
            "telephone_number": "480-607-3800",
            "fax_number": "480-607-3808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIT",
        "first_name": "ADRIENNE",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-20",
        "last_updated": "2010-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "3860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "793069-02",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.