Organization Active NPI

S K Masood MD PA

  • Nephrology Physician
  • Mesa, AZ
National Provider Identifier
1073502787
Registry record updated Oct 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
S K MASOOD MD PA
Doing business as
THE SPECIALISTS CLINIC
Practice address
215 S Power Rd Ste 104
Mesa, AZ 85206-5236
Phone
(480) 924-2288
NPI assigned
Oct 14, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2007

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

Authorized official

Name
Mr. Syed K Masood, MDNPI 1326034810
Title
President
Phone
(480) 924-2288

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
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

215 S Power Rd Ste 104
Mesa, AZ 85206-5236

Mailing address

215 S Power Rd Ste 104
Mesa, AZ 85206-5236
Phone (480) 924-2288

Other identifiers 1

IdentifierTypeStateIssuer
DE3116OtherAZRAIL ROAD MEDICARE

Other names 1

  • THE SPECIALISTS CLINIC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051114000182 AZ Part B Supplier - Clinic/Group Practice 8426077025 Receives reassigned benefits from 2 practitioners
Practice locations: Mesa, AZ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D0983568Specialists Clinic,the215 South Power Road, Suite 104, Mesa, AZ 85206Certificate of waiverFeb 25, 2027

National Provider Directory

National Provider Directory

Locations

215 S Power Rd
Ste 104
Mesa, AZ 85206
Phone (480) 924-2288

Practitioners & affiliated clinicians

Practitioners 3

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": "1129248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193356800000",
    "number": "1073502787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 S POWER RD STE 104",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852065236",
            "telephone_number": "480-924-2288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 S POWER RD STE 104",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852065236",
            "telephone_number": "480-924-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S K MASOOD MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-14",
        "last_updated": "2007-10-26",
        "status": "A",
        "authorized_official_last_name": "MASOOD",
        "authorized_official_first_name": "SYED",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-924-2288",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "DE3116",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE SPECIALISTS CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.