Active NPI
Jerald S Altman, MD
- Otolaryngology Physician
- Glendale, AZ
National Provider Identifier
1972531358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 26123
- Practice address
- 18700 N 64TH Dr
Ste 201
Glendale, AZ 85308-7114 - Phone
- (623) 566-4718
- Fax
- (623) 566-4820
- NPI assigned
- Jun 28, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 26123 | AZ | Primary |
Addresses
Primary practice location
18700 N 64TH Dr
Ste 201
Glendale, AZ 85308-7114
Mailing address
18700 N 64TH Dr
Ste 201
Glendale, AZ 85308-7114
Phone (623) 566-4718
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 424565 | Medicaid | AZ |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060227000657 | AZ | Practitioner - Otolaryngology | 0042226136 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- Ohio Medical University, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Valley ENT PC
Practice addresses (Care Compare)
9097 E Desert Cove Ave
Suite 250
Scottsdale, AZ 85260-6278
Phone (480) 847-1193
9250 W Thomas Rd
Suite 350
Phoenix, AZ 85037-3385
Phone (623) 848-8890
Hospital & facility affiliations
- St Josephs Hospital and Medical Center
- Honorhealth Deer Valley Medical Center
- Abrazo Arrowhead Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.58 of 100
- Quality
- 71.49
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 73.79
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26123 | AZ | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northern Arizona Ear Nose and Throat PC | Otolaryngology | Past | Accepting new patients |
Interoperability endpoints
- jerald.altman@1028.chartlogic.direct-ci.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.
-
- Otolaryngology Physician
- Flagstaff, AZ
- NPI 1558449900
Otolaryngology
Hospital & facility affiliations 7
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": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350000000000",
"number": "1972531358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18700 N 64TH DR",
"address_2": "STE 201",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853087114",
"telephone_number": "623-566-4718",
"fax_number": "623-566-4820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18700 N 64TH DR",
"address_2": "STE 201",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853087114",
"telephone_number": "623-566-4718",
"fax_number": "623-566-4820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALTMAN",
"first_name": "JERALD",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-28",
"last_updated": "2012-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "AZ",
"license": "26123",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "424565",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2012; 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.