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Ethan Dodge

Pediatrics β€’ Phoenix, AZ

Active NPI 1962938464 Individual Practitioner Male Practitioner
Practice location in NPPES

500 W Thomas Rd Ste 250
Phoenix, AZ 850134215

Call 6024063520 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

500 W Thomas Rd Ste 250

Phoenix, AZ 850134215

Telephone 6024063520
Fax 6024066162
Other Listings in Public Data

NPPES lists 1 additional practice-address record in Phoenix, AZ. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Industry payments (Open Payments)

Fewer than 11 payment records totaling $17.57 in 2022

Drug and medical device companies must report certain payments to doctors and some other clinicians to CMS, such as meals, travel, speaking fees or research funding.

These records are submitted by drug and medical device companies, and a reported payment does not necessarily mean the financial relationship is improper.

General: payments not tied to research, such as meals, travel, consulting or speaking fees.

A reported payment does not necessarily mean the financial relationship is improper. Research payments can go to a hospital or university for a study the clinician leads, not to the clinician personally. Clinicians can dispute records with the company that reported them.

Source: CMS Open Payments, program year 2022.

Guide: How to read an Open Payments record

NPI first issued

2017

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Ethan Dodge has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Ethan Dodge as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Phoenix and Arizona

422 active clinicians are listed under Pediatrics with a practice address in Phoenix, AZ (1,310 in Arizona).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Phoenix

0.2% of these 422 clinicians have the CMS telehealth indicator.

6.4% of these 422 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Open Payments (2022), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Pharma & Medical Device Financial Disclosures

Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments

Open Payments Β· Program Year 2022

Program year 2022 (payments made January 1 – December 31, 2022): fewer than 11 records totaling $17.57.

Manufacturer Payment Nature Product Type Amount ($)
Corium, LLC
Food and Beverage
In-kind items and services
AZSTARYS General $17.57

Source: CMS Open Payments, program year 2022, released June 30, 2026.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2024-12-09
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

License # reported to NPPES AZ 60154

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.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Arizona Medical Board.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - PEDIATRIC MEDICINE

Medicare Enrollment ID

I20200723002939

Enrollment State Jurisdiction

AZ

PECOS Control ID

4183048010

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Secondary Practice Locations

1919 E Thomas Rd, Phoenix Children's Hospital

Phoenix, AZ 85016

Phone: 6025462923

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

10 Historical Events
πŸ“
Updated Practice Location December 09, 2024

Registered at 500 W THOMAS RD STE 250, PHOENIX, AZ 850134215 (Tel: 6024063520)

πŸ“
Updated Business Mailing Address December 09, 2024

Registered at PO BOX 33269, PHOENIX, AZ 850673269 (Tel: 6024064786)

πŸ“
Updated Business Mailing Address July 27, 2020

Registered at 3200 E CAMELBACK RD STE 250, PHOENIX, AZ 850182327 (Tel: 6029331814)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 27, 2020

Pediatrics (license number reported to NPPES: AZ 60154)

βœ…
NPI Profile Active May 04, 2017

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) May 04, 2017

Registered at 1919 E THOMAS RD, PHOENIX CHILDREN'S HOSPITAL, PHOENIX, AZ 85016 (Tel: 6025462923)

πŸ“
Business Mailing Address (Initial Record) May 04, 2017

Registered at 6819 E SHEENA DR, SCOTTSDALE, AZ 852543440 (Tel: 9144092207)

πŸ‘€
Provider Name / Credentials (Initial Record) May 04, 2017

Recorded as ETHAN DODGE

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) May 04, 2017

Student in an Organized Health Care Education/Training Program

🟒
Initial NPI Registration & Enumeration May 04, 2017

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1962938464
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 04, 2017
Last Update: December 09, 2024
Sole Proprietor: No

Other Pediatrics Specialists in Phoenix

All Pediatrics Specialists in Phoenix

Mailing Address

Po Box 33269

Phoenix, AZ 850673269

Phone: 6024064786

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.