Individual provider Active NPI

Stuart John Hetrick, D.O.

  • Neurology Physician
  • Phoenix, AZ
National Provider Identifier
1932101730
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
3103 Issued in AZ
Practice address
4530 E Muirwood Dr
#111
Phoenix, AZ 85048-7639
Phone
(480) 961-2365
Fax
(480) 961-2382
NPI assigned
Aug 11, 2005
Last updated
Mar 31, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 3103 AZ Primary

Addresses

Primary practice location

4530 E Muirwood Dr
#111
Phoenix, AZ 85048-7639

Mailing address

PO Box 39179
Phoenix, AZ 85069-9179
Phone (602) 395-0718

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
I20110330000251 AZ Practitioner - Neurology 1759272487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Foothills Neurology P CGroup PAC ID 6507757234, 24 clinicians

Practice addresses (Care Compare)

15715 S 46TH St
Suite 100
Phoenix, AZ 85048-0439
Phone (480) 961-2365

4001 N 3Rd St
Suite 290
Phoenix, AZ 85012-2071
Phone (480) 961-2365

4530 E Muirwood Dr
Phoenix, AZ 85048-7693
Phone (480) 961-2365

8415 N Pima Rd
Suite 175
Scottsdale, AZ 85258-4484
Phone (480) 270-5246

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.26 of 100Reported as group
Quality
84.84
Promoting interoperability
100
Improvement activities
40
Cost
39.37

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy81

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Foothills Neurology P C Neurology CurrentSince May 25, 2001 Accepting new patients

Locations

4530 E Muirwood Dr
Ste 111
Phoenix, AZ 85048
Phone (480) 551-5469

7054 E Cochise Rd
Ste B230
Scottsdale, AZ 85253
Phone (480) 471-6132

Interoperability endpoints

  • Direct secure messaging: stuart.hetrick.1@8409.direct.athenahealth.com

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 5

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": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1932101730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 39179",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850699179",
            "telephone_number": "602-395-0718",
            "fax_number": "602-277-8146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4530 E MUIRWOOD DR",
            "address_2": "#111",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487639",
            "telephone_number": "480-961-2365",
            "fax_number": "480-961-2382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HETRICK",
        "first_name": "STUART",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AZ",
            "license": "3103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.