Organization Active NPI

Fusion Medical Care, PLLC

  • Family Medicine Physician
  • Scottsdale, AZ
National Provider Identifier
1144860800
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FUSION MEDICAL CARE, PLLC
Practice address
5900 N Granite Reef Rd Ste 102
Scottsdale, AZ 85250-6280
Phone
(602) 703-7276
NPI assigned
Jan 10, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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

Authorized official

Name
Mrs. Laura Gold, RPHNPI 1831505437
Title
Owner
Phone
(602) 703-7275

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Health Service Clinic/Center 261QH0100X
Primary Care Clinic/Center 261QP2300X
Pain Clinic/Center 261QP3300X

Addresses

Primary practice location

5900 N Granite Reef Rd Ste 102
Scottsdale, AZ 85250-6280

Mailing address

10078 E Pershing Ave
Scottsdale, AZ 85260-7221
Phone (602) 703-7275

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL tbd Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200505002488 AZ Part B Supplier - Clinic/Group Practice 4587095609 Receives reassigned benefits from 3 practitioners
Practice locations: Scottsdale, 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
03D2183631Fusion Medical Care, PLLC5900 N Granite Reef Rd Ste 102, Scottsdale, AZ 85250Certificate of waiverMay 6, 2028

National Provider Directory

National Provider Directory

Locations

5900 N Granite Reef Rd
Ste 106
Scottsdale, AZ 85250

5900 N Granite Reef Rd
Scottsdale, AZ 85250

5900 N Granite Reef Rd
Ste 102
Scottsdale, AZ 85250
Phone (480) 482-7077

5900 N Granite Reef Rd
Ste S102
Scottsdale, AZ 85250

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DEBACD

Practitioners & affiliated clinicians

Practitioners 7

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": "1578614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580860800000",
    "number": "1144860800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10078 E PERSHING AVE",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852607221",
            "telephone_number": "602-703-7275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 N GRANITE REEF RD STE 102",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852506280",
            "telephone_number": "602-703-7276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUSION MEDICAL CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-10",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A",
        "authorized_official_last_name": "GOLD",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-703-7275",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "tbd",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "5900 N Granite Reef Rd Ste 106",
            "city": "Scottsdale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852506281",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; 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.