Individual provider Active NPI

Alan Lee Ansel, MD

  • Vascular Surgery Physician
  • Tempe, AZ
National Provider Identifier
1093722142
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
7808 Issued in AZ
Practice address
2034 E Southern
4
Tempe, AZ 85282
Phone
(602) 252-2133
Fax
(602) 258-0123
NPI assigned
Aug 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 7808 AZ Primary

Addresses

Primary practice location

2034 E Southern
4
Tempe, AZ 85282

Mailing address

PO Box 7779
Phoenix, AZ 85011
Phone (602) 252-2133

Other identifiers 1

IdentifierTypeStateIssuer
213877MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040713000759 AZ Practitioner - Vascular Surgery 6305824566

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7808AZMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093722142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7779",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85011",
            "telephone_number": "602-252-2133",
            "fax_number": "602-258-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2034 E SOUTHERN",
            "address_2": "4",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "85282",
            "telephone_number": "602-252-2133",
            "fax_number": "602-258-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANSEL",
        "first_name": "ALAN",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "AZ",
            "license": "7808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213877",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

Verify at the official NPI Registry.