BRANDON EUGENE FORNWALT
NPI 1912407172
Otolaryngology in Glendale, AZ

Active since February 14, 2018PECOS EnrolledAccepts Medicare Assignment
69.24/100
CMS Quality Rating
18699 N 67TH AVE STE 300, GLENDALE, AZ 85308(623) 566-4718(523) 566-4820 Get Directions Write a Review

NPPES record last updated: July 3, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 3, 2023, Feb 14, 2018 (2 updates tracked since 2018).

About Brandon Eugene Fornwalt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRANDON EUGENE FORNWALT (NPI 1912407172) is an individual otolaryngology provider in Glendale, Arizona, licensed in Arizona (009926) and active in the NPI registry since February 2018. He is enrolled in Medicare PECOS, maintains a secondary practice location in Phoenix, and is a graduate of Arizona College Of Osteopathic Medicine Mid Western University (2018).

NPPES Registry Identity

NPI1912407172
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameBRANDON EUGENE FORNWALT
Location Address18699 N 67TH AVE STE 300Glendale, AZ 85308-7149
Mailing Address9097 E Desert Cove Ave Ste 200Scottsdale, AZ 85260-6280 · (928) 614-7516 · Fax (480) 214-9929
Fax(523) 566-4820
Sole ProprietorNo
Medical School CMSArizona College Of Osteopathic Medicine Mid Western UniversityGraduated 2018
Enumeration DateFebruary 14, 2018
Last NPPES UpdateJuly 3, 20232 updates tracked since enumeration
NPPES CertifiedJuly 3, 2023
NPI 1912407172 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License Licensed in AZ · 009926
Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

18699 N 67TH AVE STE 300, Glendale, AZ 85308

Secondary Practice Location 1

Location 19250 W Thomas Rd Ste 350Phoenix, AZ 85037-3385 · Phone (623) 848-8890 · Fax (623) 848-7848

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Brandon Eugene Fornwalt is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9133477748
PECOS Enrollment IDI20230713003148
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
216 services134 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
155 services155 patients
Removal of impacted ear wax 69210
Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.
66 services44 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
50 services50 patients
Exam of the nose and throat using an endoscope 92511
An endoscopic examination of the nose and throat is a procedure where a thin, flexible tube with a light and camera attached (endoscope) is used to view these areas in detail. It helps identify any abnormalities or issues that may be causing symptoms like difficulty swallowing, persistent cough, or nasal congestion.
39 services37 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
24 services23 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85308 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$127.71 typical visit price
range $55.44 – $168.60
Typical copayment $31.92 (range $13.86 – $42.15)
Most-billed visit code 99204
Established Patient
$69.24 typical visit price
range $17.72 – $137.41
Typical copayment $17.31 (range $4.43 – $34.35)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

69.24/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality69.86
Promoting Interoperability99
Improvement Activities40
Cost28.43

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Allergy & Immunology
18699 N 67TH AVE STE 300
GLENDALE, AZ 85308

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1912407172, enumerated as an "individual" on February 14, 2018.

The provider is located at 18699 N 67TH AVE STE 300 GLENDALE, AZ 85308 and the phone number is (623) 566-4718.

Otolaryngology with taxonomy code 207Y00000X.

The provider might be accepting Accepts: Ambetter from Arizona Complete Health, Blue Cross. Please consult your insurance carrier or call the provider to verify.