Organization Active NPI

Endocrinology, Diabetes, and Thyroid Center of Arizona PLLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Glendale, AZ
National Provider Identifier
1003005893
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
36320 Issued in AZ
Legal business name
ENDOCRINOLOGY, DIABETES, AND THYROID CENTER OF ARIZONA PLLC
Practice address
20100 N 51St Ave
Suite F-635
Glendale, AZ 85308-5125
Phone
(623) 266-7858
Fax
(623) 444-9810
NPI assigned
Oct 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jasjeet KaurNPI 1417979907
Title
MD
Phone
(602) 885-7003

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X 36320 AZ Primary

Addresses

Primary practice location

20100 N 51St Ave
Suite F-635
Glendale, AZ 85308-5125

Mailing address

20100 N 51St Ave
Suite F-635
Glendale, AZ 85308-5125
Phone (623) 266-7858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071210000128 AZ Part B Supplier - Clinic/Group Practice 5092804336 Receives reassigned benefits from 1 practitioner
Practice locations: Glendale, AZ

National Provider Directory

National Provider Directory

Locations

20100 N 51st Ave
Ste F635
Glendale, AZ 85308
Phone (623) 266-7858

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564012800000",
    "number": "1003005893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20100 N 51ST AVE",
            "address_2": "SUITE F-635",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853085125",
            "telephone_number": "623-266-7858",
            "fax_number": "623-444-9810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20100 N 51ST AVE",
            "address_2": "SUITE F-635",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853085125",
            "telephone_number": "623-266-7858",
            "fax_number": "623-444-9810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDOCRINOLOGY, DIABETES, AND THYROID CENTER OF ARIZONA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-17",
        "last_updated": "2019-07-25",
        "status": "A",
        "authorized_official_last_name": "KAUR",
        "authorized_official_first_name": "JASJEET",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "602-885-7003"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "AZ",
            "license": "36320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.