Active NPI
Jeffrey J Ptak, M.D. FACS
- Specialist
- Scottsdale, AZ
National Provider Identifier
1184604704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 12948
- Practice address
- 9431 E Ironwood Square Dr
Scottsdale, AZ 85258 - Phone
- (480) 451-9220
- Fax
- (480) 451-9226
- NPI assigned
- Jan 19, 2006
- Last updated
- Feb 21, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 12948 | AZ | Primary |
Addresses
Primary practice location
9431 E Ironwood Square Dr
Scottsdale, AZ 85258
Mailing address
9431 E Ironwood Square Dr
Scottsdale, AZ 85258
Phone (480) 451-9220
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12948 | AZ | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203552000000",
"number": "1184604704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9431 E IRONWOOD SQUARE DR",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "85258",
"telephone_number": "480-451-9220",
"fax_number": "480-451-9226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9431 E IRONWOOD SQUARE DR",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "85258",
"telephone_number": "480-451-9220",
"fax_number": "480-451-9226"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PTAK",
"first_name": "JEFFREY",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D. FACS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-19",
"last_updated": "2008-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "AZ",
"license": "12948",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.