ARIZONA STATE UNIVERSITY


Address: 4701 West Thunderbird Road, University Center Building, Room 190, Glendale, AZ 85306
Phone: 6025438019

ARIZONA STATE UNIVERSITY (NPI# 1255511465) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1255511465
Entity Type Organization
Organization Name ARIZONA STATE UNIVERSITY
Other Organization Name ARIZONA STATE UNIVERSITY HEALTH SERVICES
Practice Address 4701 West Thunderbird Road
University Center Building, Room 190
Glendale
AZ 85306
Mailing Address Po Box 872104
Tempe
AZ 85287-2104
Practice Telephone 6025438019
Practice Fax Number 6025438079
Mailing Telephone 4809653346
Mailing Fax Number 4809652269
Enumeration Date 2007-11-06
Last Update Date 2014-11-03
Authorized Official Name DR. ALLAN MARKUS (PHYSICIAN/DIRECTOR)
Authorized Official Telephone 4809651145
Authorized Official Credential M.D.
Is Organization Subpart Y
Parent Organization Name ARIZONA STATE UNIVERSITY

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207Q00000X Family Medicine Allopathic & Osteopathic Physicians
N 363LF0000X Nurse Practitioner
Specialization: Family
Physician Assistants & Advanced Practice Nursing Providers
N 207Q00000X Family Medicine AZ Allopathic & Osteopathic Physicians
Y 363LF0000X Nurse Practitioner
Specialization: Family
AZ Physician Assistants & Advanced Practice Nursing Providers

Other Provider/Organization Names

Other Name Type Code
Arizona State University Health Services Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1396072682 Arizona State University Clinic/Center 1555 N Bridalwreath St, Tempe, AZ 85281-1601 2009-11-09
1912187121 Arizona State University Family Medicine 7332 E. Sun Devil Mall, Mesa, AZ 85212 2007-11-06
1164601811 Arizona State University Clinic/Center 1124 N 3rd St, Phoenix, AZ 85004-1805 2007-10-30
1952338865 Arizona State University Audiologist Coor Hall 2211, Tempe, AZ 85287-0102 2006-06-27
1467079020 Arizona State University Clinical Medical Laboratory 1001 S Mcallister Ave, Tempe, AZ 85281-2115 2020-06-30
1063883924 Arizona State University Audiologist 975 S. Myrtle Avenue, Coor Hall 2211, Tempe, AZ 85281 2015-10-16
1477959518 Arizona State University Non-Pharmacy Dispensing Site 500 E Veterans Way, Tempe, AZ 85287-0001 2014-11-18
1821492455 Arizona State University Non-Pharmacy Dispensing Site 500 E Veterans Way, Tempe, AZ 85287-0001 2014-10-10
1265798664 Arizona State University Clinic/Center 500 N 3rd St, Phoenix, AZ 85004-2135 2012-04-10
1194058917 Arizona State University Clinic/Center 2150 E Orange St, Tempe, AZ 85281-4814 2009-09-11

Other Data Sources

Entity Type Entity Name Entity Address
North Carolina Corporations Arizona State University 1475 N Scottsdale Rd, Scottsdale, AZ 85257
System for Award Management (SAM) Entities ARIZONA STATE UNIVERSITY 300 E University Dr Ste 410, Tempe, AZ 85281-2061
Colorado Business Entities Arizona State University Foundation for A New American University 300 E University Dr, Tempe, AZ 85281
Ohio Business Entities ARIZONA STATE UNIVERSITY FOUNDATION FOR A NEW AMERICAN UNIVERSITY 300 E. University Dr., Tempe, AZ 85281
Oklahoma Business Registrations ARIZONA STATE UNIVERSITY FOUNDATION FOR A NEW AMERICAN UNIVERSITY Po Box 2260, Tempe, AZ 85280-2260

Office Location

Street Address 4701 WEST THUNDERBIRD ROAD
UNIVERSITY CENTER BUILDING, ROOM 190
City GLENDALE
State AZ
Zip Code 85306

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1548784648 Michelle Weissgerber Registered Nurse 6640 W Maui Ln, Glendale, AZ 85306 2017-07-31
1427502947 Az Interact LLC Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 6055 West Caribe Lane, Glendale, AZ 85306 2016-08-12
1649667635 Richard Moreno Jr. Physical Therapy Assistant 6509 W Acapulco Ln, Glendale, AZ 85306 2015-04-17
1568863819 Alternative Living for You Assisted Living Facility 5328 W. Tierra Buena Ln., Glendale, AZ 85306 2014-09-05
1649614561 Matthew Brownell Internal Medicine 5555 W, Thunderbird, Banner Thunderbird Medical Center, Glendale, AZ 85306 2013-04-22
1366736266 Miles Christenson Speech-Language Pathologist 14627 N 60th Ave, Glendale, AZ 85306 2011-06-08
1285928721 Nathalie Tania Petein-alamshaw Internal Medicine 5555 W Thunderbird Road, Glendale, AZ 85306 2011-06-01
1134351869 William J. Duff Counselor 5701 W. Talavi Boulevard, Suite 180, Phoenix, AZ 85306 2009-08-13
1538321369 Cardiovascular Consultants, Ltd Non-Pharmacy Dispensing Site 5422 W. Thunderbird, Suite 8, Glendale, AZ 85306 2008-07-02
1316109143 Cardiovascular Consultants, Ltd Non-Pharmacy Dispensing Site 5620 W. Thunderbird, Suite D3, Glendale, AZ 85306 2008-07-02
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1770199481 Steven Cleo Northern Jr. Nurse Practitioner 5820 W Greenway Rd Ste 124, Glendale, AZ 85306-3308 2020-09-17
1609493279 Traci Marie Miramontes Nurse Practitioner 6001 W Northview Ave, Glendale, AZ 85301-1857 2020-06-30
1669097697 Swazi Cromwell Nurse Practitioner 13408 N 53rd Ave, Glendale, AZ 85304-1378 2020-06-16
1922620590 Bethany E Mainville Nurse Practitioner 8151 W Sierra Vista Dr, Glendale, AZ 85303-3217 2020-05-17
1184252678 Revive Wellness and Rejuvenation LLC Nurse Practitioner 20229 N 67th Ave Ste C-a, Glendale, AZ 85308-6664 2020-03-30
1083247316 Anna Lazzaro Nurse Practitioner 4760 W Ponderosa Ln, Glendale, AZ 85308-4872 2020-02-14
1760021422 Judy Fong Nurse Practitioner 5220 W Dahlia Dr, Glendale, AZ 85304-1931 2019-12-29
1588207138 Kristen Mitchell Nurse Practitioner 6922 W Kristal Way, Glendale, AZ 85308-5772 2019-10-25
1760038335 Adrineh Kalantar Ohanian Nurse Practitioner 1139 E Lexington Dr, Glendale, CA 91206-3861 2019-08-09
1457904252 Debra Goldman Nurse Practitioner 20325 N 51st Ave # 8, Glendale, AZ 85308-5674 2019-07-20
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Competitor

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City GLENDALE
Zip Code 85306

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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