DR. ETHAN DODGE - NPI 1962938464 - Pediatrics in Phoenix, AZ

Q: What is Ethan Dodge's NPI number?

The NPI number for Ethan Dodge is 1962938464. It was assigned to this individual provider in the NPPES registry on May 4, 2017.

Q: What is Ethan Dodge's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Ethan Dodge was last updated on December 9, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Dr. Ethan Dodge NPPES

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

DR. ETHAN DODGE (NPI 1962938464) is an individual pediatrics provider in Phoenix, Arizona, licensed in Arizona (60154) and active in the NPI registry since May 2017. He is enrolled in Medicare PECOS and maintains a secondary practice location in Phoenix.

NPPES Registry Identity

NPI1962938464

Entity TypeIndividualMale

Primary Taxonomy208000000X

Provider Legal NameDR. ETHAN DODGE

Location Address500 W THOMAS RD STE 250Phoenix, AZ 85013-4215

Mailing AddressPo Box 33269Phoenix, AZ 85067-3269 · (602) 406-4786 · Fax (916) 636-4358

Phone(602) 406-3520

Fax(602) 406-6162

Sole ProprietorNo

Enumeration DateMay 4, 2017

Last NPPES UpdateDecember 9, 20243 updates tracked since enumeration

NPPES CertifiedDecember 9, 2024

✔ NPI 1962938464 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in AZ · 60154

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

500 W THOMAS RD STE 250, Phoenix, AZ 85013

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Secondary Practice Location 1

Location 11919 E Thomas Rd, Phoenix Children's HospitalPhoenix, AZ 85016 · Phone (602) 546-2923

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Ethan Dodge is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85013 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

$85.89 typical visit price

range $55.44 – $168.60

Typical copayment $21.47 (range $13.86 – $42.15)

Most-billed visit code 99203

Established Patient

$98.00 typical visit price

range $17.72 – $137.41

Typical copayment $24.50 (range $4.43 – $34.35)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 12

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

DR. WENDY CARLTON MD

Pediatrics