Phoenix Infectious Diseases Consultants LLC

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

30584 Issued in AZ

Legal business name

PHOENIX INFECTIOUS DISEASES CONSULTANTS LLC

Practice address

3330 N 2ND St Ste 401
Phoenix, AZ 85012-2371

Phone

(602) 254-1136

Fax

(602) 279-1720

NPI assigned

May 6, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Ndidiamaka U Obiesie, MDNPI 1770579492

Title

Owner/ President

Phone

(602) 790-4108

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Tax ID family

Phoenix Infectious Disease Cons2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Phoenix Infectious Diseases Consultants, LLC

  • Infectious Disease Physician
  • Phoenix, AZ
  • NPI 1396977963
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ndidiamaka Uzoma Obiesie, MD

  • Infectious Disease Physician
  • Phoenix, AZ
  • NPI 1770579492
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417478400000",
    "number": "1235305574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 E MCDOWELL RD STE 107-609",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041549",
            "telephone_number": "602-790-4108",
            "fax_number": "623-218-9209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 N 2ND ST STE 401",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122371",
            "telephone_number": "602-254-1136",
            "fax_number": "602-279-1720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX INFECTIOUS DISEASES CONSULTANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-06",
        "last_updated": "2014-12-02",
        "status": "A",
        "authorized_official_last_name": "OBIESIE",
        "authorized_official_first_name": "NDIDIAMAKA",
        "authorized_official_middle_name": "U",
        "authorized_official_title_or_position": "OWNER/ PRESIDENT",
        "authorized_official_telephone_number": "602-790-4108",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "AZ",
            "license": "30584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE UNSPEC",
            "identifier": "71505",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "763062",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Infectious Disease Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Infectious Disease Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.