Individual provider Active NPI

Thylma Lynn Sta Maria, MD

  • Obstetrics & Gynecology Physician
  • Glendale, AZ
National Provider Identifier
1114983822
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
33222 Issued in AZ
Practice address
6320 W Union Hills Dr Ste 100
Glendale, AZ 85308-1099
Phone
(480) 821-3600
Fax
(480) 857-2667
NPI assigned
Apr 21, 2006
Last updated
Nov 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 33222 AZ Primary

Addresses

Primary practice location

6320 W Union Hills Dr Ste 100
Glendale, AZ 85308-1099

Mailing address

PO Box 6730
Chandler, AZ 85246-6730
Phone (480) 821-3600

Other identifiers 1

IdentifierTypeStateIssuer
892704MedicaidAZ

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
I20040916000475 AZ Practitioner - Obstetrics/Gynecology 0840267688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
New York University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Momdoc LLCGroup PAC ID 3375534282, 62 clinicians

Practice addresses (Care Compare)

Chandler, AZ 85224
Phone (480) 821-3600

6320 W Union Hills Dr
Suite 100
Glendale, AZ 85308-1099
Phone (480) 821-3600

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Estrella Medical Center Past Accepting new patients
VHS of Arrowhead, Inc Past Accepting new patients
Healthy Pregnancy Perinatology, LLC PastSince Nov 26, 2023 Accepting new patients
All Womens OB GYN Care P C Obstetrics & Gynecology Past Accepting new patients

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1114983822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6730",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852466730",
            "telephone_number": "480-821-3600",
            "fax_number": "480-857-2667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6320 W UNION HILLS DR STE 100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081099",
            "telephone_number": "480-821-3600",
            "fax_number": "480-857-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STA MARIA",
        "first_name": "THYLMA",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-21",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "33222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "892704",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.