Individual provider Active NPI

Serjik Nazarian, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Cottonwood, AZ
National Provider Identifier
1215994561
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
0380 Issued in AZ
Practice address
401 S Calvary Way
Ste a
Cottonwood, AZ 86326-4165
Phone
(928) 282-3305
Fax
(928) 282-6816
NPI assigned
Apr 28, 2006
Last updated
Sep 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 0380 AZ Primary

Addresses

Primary practice location

401 S Calvary Way
Ste a
Cottonwood, AZ 86326-4165

Mailing address

401 S Calvary Way
Ste a
Cottonwood, AZ 86326-4165
Phone (928) 282-3305

Other identifiers 1

IdentifierTypeStateIssuer
149262MedicaidAZ

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060606000288 AZ Practitioner - Podiatry 5193736270 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

269 S Candy LN
Cottonwood, AZ 86326-4158
Phone (928) 282-3305

3124 Willow Creek Rd
Prescott, AZ 86301-6610
Phone (928) 282-3305

401 S Calvary Way
Suite a
Cottonwood, AZ 86326-4165
Phone (928) 282-3305

401 S Calvary Way a
Cottonwood, AZ 86326-4165

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
8.73 of 100Reported as individual
Quality
15
Improvement activities
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue98
Removal of nail tissue178
Removal or shaving of skin growth199

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0380AZMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sedona Foot & Ankle Specialists P C Foot & Ankle Surgery CurrentSince May 1, 2002 Accepting new patients

Locations

401 S Calvary Way
Ste A
Cottonwood, AZ 86326
Phone (928) 282-3305

3124 Willow Creek Rd
Prescott, AZ 86301
Phone (928) 371-4700

105 Roadrunner Dr
Ste 3
Sedona, AZ 86336
Phone (602) 282-3305

Organizations & group practices 1

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1215994561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S CALVARY WAY",
            "address_2": "STE A",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863264165",
            "telephone_number": "928-282-3305",
            "fax_number": "928-282-6816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 S CALVARY WAY",
            "address_2": "STE A",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863264165",
            "telephone_number": "928-282-3305",
            "fax_number": "928-282-6816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAZARIAN",
        "first_name": "SERJIK",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-28",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AZ",
            "license": "0380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149262",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottonwood, AZ

Sources for this page

Verify at the official NPI Registry.