Sandlot Pediatrics & Young Adults, LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

29730 Issued in AZ

Legal business name

SANDLOT PEDIATRICS & YOUNG ADULTS, LLC

Practice address

2600 E Southern Ave
BLDG H
Tempe, AZ 85282-7610

Phone

(480) 699-7248

Fax

(480) 664-1961

NPI assigned

Mar 8, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Nicolas Antonio Gonzalez, M.D

Title

Physician

Phone

(480) 699-7248

Specialties & licenses 2

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1268006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441929600000",
    "number": "1285957134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 E SOUTHERN AVE",
            "address_2": "BLDG- H",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "85282",
            "telephone_number": "480-699-7248",
            "fax_number": "480-664-1961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 E SOUTHERN AVE",
            "address_2": "BLDG H",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827610",
            "telephone_number": "480-699-7248",
            "fax_number": "480-664-1961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDLOT PEDIATRICS & YOUNG ADULTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-08",
        "last_updated": "2015-09-11",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "NICOLAS",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "480-699-7248",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "29730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanne M Sanderl, LPC
• Brent C. Sanders, MD
• Cheryl Lynn Sanders, MC, LPC
• Jaime Sanders
• Prabhsharan Sandhu
• Susan F Sandmann-Uy, MD
• Estrella Marina Sandoval-Becker, NMD
• Nicole Sandoval
• Sandra Yee, MD, Inc.
• Sebakara Sandrali

• Pediatrics Physician in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.