Academic Urology and Urogynecology of Arizona PC

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

33193 Issued in AZ

Legal business name

ACADEMIC UROLOGY AND UROGYNECOLOGY OF ARIZONA PC

Practice address

14044 W Camelback Rd
Suite 118 and 216
Litchfield Park, AZ 85340-9428

Phone

(623) 547-2600

Fax

(623) 547-1899

NPI assigned

May 3, 2008

Last updated

Feb 19, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Alan Stern, M.D.NPI 1558341834

Title

Owner

Phone

(623) 547-2600

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeffrey A Stern, M.D.

  • Urology Physician
  • Litchfield Park, AZ
  • NPI 1558341834
  Authorized official Same address or phone
• Debra Dover Sullivan, PA

  • Physician Assistant
  • Litchfield Park, AZ
  • NPI 1205005311
  NPD
• Katie Ellen Wall, FNP

  • Family Nurse Practitioner
  • Litchfield Park, AZ
  • NPI 1649584384
  NPD (past)

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

{
    "created_epoch": "1209772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455840000000",
    "number": "1164698783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14044 W CAMELBACK RD",
            "address_2": "SUITE 118",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853409428",
            "telephone_number": "623-547-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14044 W CAMELBACK RD",
            "address_2": "SUITE 118 AND 216",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853409428",
            "telephone_number": "623-547-2600",
            "fax_number": "623-547-1899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACADEMIC UROLOGY AND UROGYNECOLOGY OF ARIZONA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-03",
        "last_updated": "2016-02-19",
        "status": "A",
        "authorized_official_last_name": "STERN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-547-2600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "AZ",
            "license": "33193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "575948",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARICOPA PTAN",
            "identifier": "Z180412",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESCOTT- PTAN",
            "identifier": "Z180474",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Urology Physician in Litchfield Park, AZ
• Providers in Litchfield Park, AZ by specialty
• Urology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2016; 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.