Individual provider Active NPI

Evan S Lederman, MD

  • Orthopaedic Surgery Physician
  • Phoenix, AZ
National Provider Identifier
1932183456
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
24539 Issued in AZ
Practice address
2222 E Highland Ave
Ste 300
Phoenix, AZ 85016-4872
Phone
(602) 277-6211
Fax
(866) 846-8709
NPI assigned
Nov 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 24539 AZ Primary

Addresses

Primary practice location

2222 E Highland Ave
Ste 300
Phoenix, AZ 85016-4872

Mailing address

2222 E Highland Ave
Ste 300
Phoenix, AZ 85016-4872
Phone (602) 277-6211

Other identifiers 1

IdentifierTypeStateIssuer
363979MedicaidAZ

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
I20040422001434 AZ Practitioner - Orthopedic Surgery 5092602334 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Medical College of Wisconsin, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

755 E McDowell Rd
Phoenix, AZ 85006-2506
Phone (602) 521-3086

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Quality
69.75
Promoting interoperability
98
Improvement activities
40
Cost
68.18

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24539AZMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner - University Physician Specialists LLC CurrentSince Nov 4, 2019 Accepting new patients
The Orthopedic Clinic Association, Inc Orthopaedic Surgery CurrentSince Jan 1, 1999 Accepting new patients
Banner - University Physician Specialists LLC CurrentSince Nov 4, 2019 Accepting new patients
Banner - University Hospital Based Physicians LLC CurrentSince Mar 1, 2020 Accepting new patients
Banner - University Hospital Based Physicians LLC CurrentSince Mar 1, 2020 Accepting new patients

Locations

1300 N 12th St
Ste 508
Phoenix, AZ 85006
Phone (602) 839-3927

2222 E Highland Ave
Ste 300
Phoenix, AZ 85016
Phone (602) 483-6165

4200 E Camelback Rd
Ste 104
Phoenix, AZ 85018
Phone (602) 229-2110

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

755 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 271-5111

7400 N Dobson Rd
Ste 201
Scottsdale, AZ 85256
Phone (480) 733-7400

Interoperability endpoints

  • Direct secure messaging: evanlederman@direct.summit-healthcare.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 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": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214352000000",
    "number": "1932183456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 E HIGHLAND AVE",
            "address_2": "STE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164872",
            "telephone_number": "602-277-6211",
            "fax_number": "866-846-8709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 E HIGHLAND AVE",
            "address_2": "STE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164872",
            "telephone_number": "602-277-6211",
            "fax_number": "866-846-8709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDERMAN",
        "first_name": "EVAN",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2008-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "24539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "363979",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.