Syed T Azam, MD
Individual provider Active NPI Internal Medicine Physician · Vail, AZ
NPI 1225024573 · NPPES record last updated Nov 3, 2011
Key facts
- NPI
- 1225024573
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 31208 (AZ)
- Practice address
- 13180 E Colossal Cave Rd
Suite 150
Vail, AZ 85641-9794 - Phone
- (520) 762-1557
- Fax
- (520) 762-8019
- NPI assigned
- Sep 22, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
13180 E Colossal Cave Rd
Suite 150
Vail, AZ 85641-8757
Phone (520) 762-1557
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090313000263 | AZ | Practitioner - Internal Medicine | 1759447931 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31208 | AZ | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanz Inc. | Current |
Accepting new patients |
Locations
13180 E Colossal Cave Rd
Ste 150
Vail, AZ 85641
Phone (520) 762-1557
Interoperability endpoints
- syed.azam.1@33691.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 31208 | AZ | Yes |
Addresses
Primary practice location
13180 E Colossal Cave Rd
Suite 150
Vail, AZ 85641-9794
Mailing address
13180 E Colossal Cave Rd
Suite 150
Vail, AZ 85641-9794
Phone (520) 762-1557
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 758683 | Medicaid | AZ |
Other providers in Vail, AZ
- Minette Atemafac Anu
- Apex Physical Therapy, LLC
- Maria Cristina Armenta
- Folefac Asongtia
- Atypical Therapist LLC
- Back to Home Health Inc.
- Diva Back
- Yvonne Barnett
- Garnet J Bast
- Johana Vanessa Basurto
All providers in Vail, AZ · Internal Medicine Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 3, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.