Active NPI
Douglas Brian Fridsma, M.D.
- Internal Medicine Physician
- Scottsdale, AZ
National Provider Identifier
1215010202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 40945
- Practice address
- 13400 E Shea Blvd
Scottsdale, AZ 85259-5404 - Phone
- (480) 301-8000
- NPI assigned
- Oct 23, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD07267L | PA | |
| Internal Medicine Physician | 207R00000X | G73153 | CA | |
| Internal Medicine Physician | 207R00000X | 40945 | AZ | Primary |
Addresses
Primary practice location
13400 E Shea Blvd
Scottsdale, AZ 85259-5404
Mailing address
13400 E Shea Blvd
Scottsdale, AZ 85259-5404
Phone (480) 301-8000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 383411 | Medicaid | AZ | |
| P00816014 | Other | AZ | RAILROAD MEDICARE |
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 |
|---|---|---|---|
| G73153 | CA | MD | Internal Medicine Physician |
| MD07267L | PA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274832000000",
"number": "1215010202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13400 E SHEA BLVD",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852595404",
"telephone_number": "480-301-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13400 E SHEA BLVD",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852595404",
"telephone_number": "480-301-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRIDSMA",
"first_name": "DOUGLAS",
"middle_name": "BRIAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-23",
"last_updated": "2010-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "MD07267L",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "G73153",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AZ",
"license": "40945",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "383411",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00816014",
"state": "AZ"
}
],
"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 May 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.