Individual provider Active NPI

Estrella Marina Sandoval-Becker, NMD

  • General Practice Physician
  • Tempe, AZ
National Provider Identifier
1063066496
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
19-1808 Issued in AZ
Practice address
1631 E Guadalupe Rd Ste 104
Tempe, AZ 85283-3935
Phone
(480) 330-4818
Fax
(833) 301-0796
NPI assigned
Jul 24, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 19-1808 AZ Primary

Addresses

Primary practice location

1631 E Guadalupe Rd Ste 104
Tempe, AZ 85283-3935

Mailing address

1631 E Guadalupe Rd Ste 104
Tempe, AZ 85283-3935
Phone (480) 330-4818

Other practice location 1

1902 E Baseline Rd Ste 6
Mesa, AZ 85204-6815
Phone (480) 306-7376

Other practice location 2

1955 N Val Vista Dr Ste 103
Mesa, AZ 85213-3218
Phone (480) 306-8111

Other identifiers 1

IdentifierTypeStateIssuer
19-1808OtherAZGENERAL MED

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL ChARMEHR Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
19-1808AZMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mesa Naturopathic, PLLC PastSince Apr 9, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1063066496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 E GUADALUPE RD STE 104",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852833935",
            "telephone_number": "480-330-4818",
            "fax_number": "833-301-0796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 E GUADALUPE RD STE 104",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852833935",
            "telephone_number": "480-330-4818",
            "fax_number": "833-301-0796"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1902 E Baseline Rd Ste 6",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852046815",
            "country_code": "US",
            "telephone_number": "480-306-7376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1955 N Val Vista Dr Ste 103",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852133218",
            "country_code": "US",
            "telephone_number": "480-306-8111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDOVAL-BECKER",
        "first_name": "ESTRELLA",
        "middle_name": "MARINA",
        "name_prefix": "Dr.",
        "credential": "NMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-24",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AZ",
            "license": "19-1808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GENERAL MED",
            "identifier": "19-1808",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "ChARMEHR",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "SIM",
            "address_1": "2525 S Rural Rd Ste 4N",
            "city": "Tempe",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852822442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.