Individual provider Active NPI

Samina Ayub, M.D.

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1043658271
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
56800 Issued in AZ
Practice address
4545 E Chandler Blvd Ste 104
Phoenix, AZ 85048-7647
Phone
(480) 728-4400
Fax
(480) 728-4411
NPI assigned
Jun 10, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 029-T1 WY
Family Medicine Physician 207Q00000X 56800 AZ Primary

Addresses

Primary practice location

4545 E Chandler Blvd Ste 104
Phoenix, AZ 85048-7647

Mailing address

PO Box 33269
Phoenix, AZ 85067-3269
Phone (602) 406-4786

Other practice location 1

655 S Dobson Rd Ste B113
Chandler, AZ 85224-5667
Phone (480) 728-5020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190911000745 AZ Practitioner - Family Practice 8224272802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sjhmc Physician ServicesGroup PAC ID 4486646197, 645 clinicians

Practice addresses (Care Compare)

21300 N John Wayne Pkwy
DHMG Family Medicine Maricopa
Maricopa, AZ 85139-8979
Phone (520) 426-3424

Hospital & facility affiliations

  • Mercy Gilbert Medical Center Hospital, Gilbert, AZ, CCN 030119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
56800AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sjhmc Physician Services CurrentSince Aug 1, 2019 Accepting new patients
St. Joseph'S Hospital and Medical Center CurrentSince Aug 30, 2020 Accepting new patients
Medi Horizons Inc Family Medicine Past Accepting new patients

Locations

655 S Dobson Rd
Ste B113
Chandler, AZ 85224
Phone (480) 728-5020

21300 N John Wayne Pkwy
Ste 115
Maricopa, AZ 85139
Phone (520) 426-3424

21300 N John Wayne Pkwy
Maricopa, AZ 85139
Phone (520) 374-2462

2927 N 7th Ave
Phoenix, AZ 85013
Phone (602) 406-3153

500 W Thomas Rd
Ste 680
Phoenix, AZ 85013
Phone (602) 406-6017

4545 E Chandler Blvd
Ste 104
Phoenix, AZ 85048
Phone (480) 728-4400

3030 N Central Ave
Ste 1001
Phoenix, AZ 85012

File 56765
Los Angeles, CA 90074

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1370822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1043658271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33269",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850673269",
            "telephone_number": "602-406-4786",
            "fax_number": "916-636-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 E CHANDLER BLVD STE 104",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487647",
            "telephone_number": "480-728-4400",
            "fax_number": "480-728-4411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "655 S Dobson Rd Ste B113",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852245667",
            "country_code": "US",
            "telephone_number": "480-728-5020",
            "fax_number": "480-899-5023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AYUB",
        "first_name": "SAMINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-10",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WY",
            "license": "029-T1",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "56800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.