Active NPI
Glen Bowman, MD
- Anesthesiology Physician
- Phoenix, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 73631
- Practice address
- 350 W Thomas Rd
Attn: Bni Surgical Suite
Phoenix, AZ 85013 - Phone
- (602) 406-3541
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | G185046 | CA | |
| Anesthesiology Physician | 207L00000X | 319122-1205 | UT | |
| Anesthesiology Physician | 207L00000X | 73631 | AZ | Primary |
Addresses
Primary practice location
350 W Thomas Rd
Attn: Bni Surgical Suite
Phoenix, AZ 85013
Mailing address
240 W Thomas Rd # 301
Phoenix, AZ 85013-4407
Phone (602) 406-6238
Other practice location 1
1900 Sullivan Ave
Daly City, CA 94015-2200
Phone (408) 354-9254
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TPRA09326 | Other | UT | MOLINA |
| 2090168 | Other | UT | UNITED HEALTHCARE |
| 107028042101 | Other | UT | IHC |
| 77515 | Other | UT | PEHP |
| 806868300 | Medicaid | ID | |
| 851001 | Other | UT | DESERET MUTUAL |
| 858409 | Medicaid | AZ | |
| 100503208 | Medicaid | NV | |
| 119647200 | Medicaid | WY | |
| 1502954 | Other | UT | UMWA |
| QM0000075886 | Other | UT | ALTIUS |
| 835388 | Other | UT | HEALTHY U |
| 870545614BOW | Other | UT | EDUCATORS MUTUAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT, CA, AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
500 W Thomas Rd
680 DHMG St Joseph's Pelvic Pain and Surg
Phoenix, AZ 85013-4235
Phone (602) 406-6017
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 73631 | AZ | MD | Anesthesiology Physician |
| G185046 | CA | MD | Anesthesiology Physician |
| 319122-1205 | UT | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sjhmc Physician Services | Current | Accepting new patients | |
| St. Joseph's Hospital and Medical Center | Current | Accepting new patients | |
| Anesthesia Care Consultants Inc | Anesthesiology | Current | Accepting new patients |
| St. Joseph's Outpatient Surgery Center, LLC | Current | Accepting new patients | |
| Mountain West Anesthesia LLC | Anesthesiology | Current | Accepting new patients |
Locations
350 W Thomas Rd
Phoenix, AZ 85013
Phone (480) 339-5001
240 W Thomas Rd
#301
Phoenix, AZ 85013
Phone (602) 406-6262
500 W Thomas Rd
Ste 680
Phoenix, AZ 85013
Phone (602) 406-6017
1849 Bayshore Hwy
#3
Burlingame, CA 94010
1900 Sullivan Ave
Daly City, CA 94015
Phone (650) 991-6503
File 56765
Los Angeles, CA 90074
104 Saint Matthews Ave
San Mateo, CA 94401
Phone (650) 344-8700
3340 N Center St
Ste 800
Lehi, UT 84043
Phone (800) 501-4788
3741 W 12600 S
Riverton, UT 84065
Phone (801) 285-2400
150 W Civic Center Dr
Ste 200
Sandy, UT 84070
Phone (801) 727-2056
1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355
Interoperability endpoints
- gbowman682498@hisp.ehr.sutterhealth.org
Organizations & group practices 5
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.
-
dba St. Joseph's Faculty Physicians
- Multi-Specialty Clinic/Center
- Phoenix, AZ
- NPI 1326098005
-
- Anesthesiology Physician
- Daly City, CA
- NPI 1639524309
-
- Anesthesiology Physician
- Lehi, UT
- NPI 1558391763
-
dba SJHMC Trauma Services
- Emergency Care Clinic/Center
- Phoenix, AZ
- NPI 1255382412
-
- Ambulatory Surgical Clinic/Center
- Phoenix, AZ
- NPI 1306843222
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba St. Josephs Hospital and Medical Center Emergency Dept-Litchfield Park
- Emergency Care Clinic/Center
- Litchfield Park, AZ
- NPI 1265065445
Hospital
-
dba St. Josephs Hospital and Medical Center Emergency Dept-Glendale
- Emergency Care Clinic/Center
- Glendale, AZ
- NPI 1609408665
Hospital
-
dba St. Joseph's Hospital and Medical Center
- General Acute Care Hospital
- Phoenix, AZ
- NPI 1982733655
-
dba St. Joseph's Westgate Medical Center
- General Acute Care Hospital
- Glendale, AZ
- NPI 1992131734
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721347200000",
"number": "1922110238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 W THOMAS RD # 301",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850134407",
"telephone_number": "602-406-6238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 W THOMAS RD",
"address_2": "ATTN: BNI SURGICAL SUITE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85013",
"telephone_number": "602-406-3541"
}
],
"practiceLocations": [
{
"address_1": "1900 Sullivan Ave",
"address_purpose": "LOCATION",
"city": "Daly City",
"state": "CA",
"postal_code": "940152200",
"country_code": "US",
"telephone_number": "408-354-9254",
"fax_number": "918-213-4399",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOWMAN",
"first_name": "GLEN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2024-07-19",
"certification_date": "2024-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "G185046",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "UT",
"license": "319122-1205",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "AZ",
"license": "73631",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MOLINA",
"identifier": "TPRA09326",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "2090168",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IHC",
"identifier": "107028042101",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PEHP",
"identifier": "77515",
"state": "UT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "806868300",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DESERET MUTUAL",
"identifier": "851001",
"state": "UT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "858409",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100503208",
"state": "NV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "119647200",
"state": "WY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UMWA",
"identifier": "1502954",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALTIUS",
"identifier": "QM0000075886",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHY U",
"identifier": "835388",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EDUCATORS MUTUAL",
"identifier": "870545614BOW",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.