Manzanita Medical PLLC
NPI 1306376611 · Family Medicine Physician · Phoenix, AZ
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Manzanita Medical PLLC is a Family Medicine Physician organization in Phoenix, AZ (NPI 1306376611).
Provider details
- NPI number
- 1306376611
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Judith Hallas, Office Manager(480) 292-9532
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2017-06-19
- Last updated
- 2024-07-23
- Certified
- 2023-05-08
Frequently asked questions
- What is Manzanita Medical PLLC's NPI number?
- Manzanita Medical PLLC's National Provider Identifier (NPI) is 1306376611, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Manzanita Medical PLLC?
- Manzanita Medical PLLC is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Manzanita Medical PLLC located?
- Manzanita Medical PLLC's practice location on file with NPPES is 4545 E Shea Blvd Ste 130, Phoenix, AZ 85028-3061.
- What is Manzanita Medical PLLC's phone number?
- The practice phone number listed in the NPPES registry for Manzanita Medical PLLC is (480) 292-9532.
- Does Manzanita Medical PLLC accept Medicare?
- Manzanita Medical PLLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Manzanita Medical PLLC?
- The authorized official listed on Manzanita Medical PLLC's NPPES record is Judith Hallas, Office Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Manzanita Medical PLLC's NPI active?
- Yes — Manzanita Medical PLLC's NPI (1306376611) is active in the NPPES registry as of the last update on 2024-07-23.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.