Individual provider Active NPI

Sondema Nkipmo Tarr, DPM

  • Podiatrist
  • Tempe, AZ
National Provider Identifier
1295260180
Registry record updated Feb 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
POD-000969 Issued in AZ
Practice address
4685 S Ash Ave # Siteh1
Tempe, AZ 85282-6857
Phone
(602) 638-2718
NPI assigned
Apr 27, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X POD-000969 AZ Primary

Addresses

Primary practice location

4685 S Ash Ave # Siteh1
Tempe, AZ 85282-6857

Mailing address

PO Box 772294
Detroit, MI 48277-2294
Phone (847) 504-5000

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
I20200728000639 AZ Practitioner - Podiatry 9638594153 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Onesource Senior Healthcare PLLCGroup PAC ID 6901026988, 13 clinicians

Practice addresses (Care Compare)

16427 N Scottsdale Rd
Suite 410
Scottsdale, AZ 85254-7102
Phone (888) 495-4489

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1780
Removal or shaving of skin growth174

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Onesource Senior Healthcare PLLC Single Specialty CurrentSince Feb 20, 2023 Accepting new patients
Preferred Podiatry Group PC Single Specialty CurrentSince Mar 21, 2022 Accepting new patients
Direct Podiatry Arizona Single Specialty CurrentSince Apr 6, 2023 Accepting new patients

Locations

16427 N Scottsdale Rd
Ste 410
Scottsdale, AZ 85254
Phone (480) 418-1932

4685 S Ash Ave
#1
Tempe, AZ 85282
Phone (602) 638-2718

1650 N Santa Rosa Ave
Tucson, AZ 85712
Phone (520) 795-1610

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1295260180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 772294",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482772294",
            "telephone_number": "847-504-5000",
            "fax_number": "844-554-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4685 S ASH AVE # SITEH1",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852826857",
            "telephone_number": "602-638-2718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARR",
        "first_name": "SONDEMA",
        "middle_name": "NKIPMO",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-27",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "AZ",
            "license": "POD-000969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

Verify at the official NPI Registry.