Individual provider Active NPI

Jaclyn Therese Cronin, D.O.

  • Internal Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1992237184
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
008381 Issued in AZ
Practice address
26224 N Tatum Blvd Ste 5
Phoenix, AZ 85050-7500
Phone
(480) 882-7580
Fax
(480) 563-7442
NPI assigned
Mar 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2022

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 008381 AZ Primary

Addresses

Primary practice location

26224 N Tatum Blvd Ste 5
Phoenix, AZ 85050-7500

Mailing address

26224 N Tatum Blvd Ste 5
Phoenix, AZ 85050-7500
Phone (480) 882-7580

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200812001091 AZ Practitioner - Internal Medicine 8123398708 Reassigns benefits to 2 organizations
I20240125003104 WI Practitioner - Internal Medicine 8123398708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspirus Wausau Hospital IncGroup PAC ID 6406757442, 242 clinicians

Practice addresses (Care Compare)

425 Wind Ridge Dr
Wausau, WI 54401-4149
Phone (715) 675-3391

Hospital & facility affiliations

  • Aspirus Wausau Hospital Hospital, Wausau, WI, CCN 520030

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
008381AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Honorhealth Medical Group, LLC CurrentSince Apr 19, 2022 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Feb 12, 2024 Accepting new patients
Honorhealth Ambulatory CurrentSince Aug 17, 2020 Accepting new patients
Honorhealth Medical Group, LLC CurrentSince Apr 19, 2022 Accepting new patients
Honorhealth Medical Group, LLC Current Accepting new patients
Honorhealth Ambulatory CurrentSince Aug 17, 2020 Accepting new patients
Aspirus Wausau Hospital, Inc. Internal Medicine Current Accepting new patients
Honorhealth Ambulatory Current Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Feb 12, 2024 Accepting new patients
Honorhealth Ambulatory Internal Medicine Past Accepting new patients

Locations

3648 W Anthem Way
Ste A100
Anthem, AZ 85086
Phone (623) 434-6444

6220 W Bell Rd
Ste 130
Glendale, AZ 85308
Phone (602) 547-7348

6220 W Bell Rd
Ste 100
Glendale, AZ 85308
Phone (602) 547-7200

20330 N Cave Creek Rd
Ste 160
Phoenix, AZ 85024
Phone (602) 730-8443

19636 N 27th Ave
Ste 308
Phoenix, AZ 85027
Phone (623) 780-1999

2500 W Utopia Rd
Ste 100
Phoenix, AZ 85027
Phone (623) 683-4462

26224 N Tatum Blvd
Ste 5
Phoenix, AZ 85050
Phone (480) 587-6775

18404 N Tatum Blvd
Ste 101
Phoenix, AZ 85032
Phone (602) 992-1900

8405 N Pima Center Pkwy
Ste 203
Scottsdale, AZ 85258
Phone (480) 587-6930

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

10510 N 92nd St
Ste 200
Scottsdale, AZ 85258
Phone (480) 323-1250

20745 N Scottsdale Rd
Ste 100
Scottsdale, AZ 85255
Phone (480) 587-5460

450 E Rio Salado Pkwy
Bldg C
Tempe, AZ 85281
Phone (480) 882-7380

29980 Network Pl
Chicago, IL 60673

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

425 Wind Ridge Dr
Wausau, WI 54401
Phone (715) 675-3391

Organizations & group practices 10

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 10

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": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1992237184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26224 N TATUM BLVD STE 5",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850507500",
            "telephone_number": "480-882-7580",
            "fax_number": "480-563-7442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26224 N TATUM BLVD STE 5",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850507500",
            "telephone_number": "480-882-7580",
            "fax_number": "480-563-7442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRONIN",
        "first_name": "JACLYN",
        "middle_name": "THERESE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-28",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "008381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.