Active NPI
Sean Benedict D'Souza, MD
- Vascular Surgery Physician
- Peoria, AZ
National Provider Identifier
1306043211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 40387
- Practice address
- 9192 W Union Hills Dr
Peoria, AZ 85382-8208 - Phone
- (602) 374-4101
- Fax
- (602) 441-0522
- NPI assigned
- Jul 3, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | 49960 | MN | |
| Vascular Surgery Physician | 2086S0129X | 40387 | AZ | Primary |
Addresses
Primary practice location
9192 W Union Hills Dr
Peoria, AZ 85382-8208
Mailing address
9192 W Union Hills Dr
Peoria, AZ 85382-8208
Phone (602) 374-4101
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 423119 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40387 | AZ | MD | Vascular Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cardiovascular Consultants LTD | Past | Accepting new patients | |
| Arizona Vein and Vascular Center LLC | Vascular Surgery | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Vascular Surgery Physician
- Surprise, AZ
- NPI 1083999361
-
- Medical Specialty Clinic/Center
- Phoenix, AZ
- NPI 1023073525
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410480000000",
"number": "1306043211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9192 W UNION HILLS DR",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853828208",
"telephone_number": "602-374-4101",
"fax_number": "602-441-0522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9192 W UNION HILLS DR",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853828208",
"telephone_number": "602-374-4101",
"fax_number": "602-441-0522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "D'SOUZA",
"first_name": "SEAN",
"middle_name": "BENEDICT",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-03",
"last_updated": "2014-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "MN",
"license": "49960",
"primary": false
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "AZ",
"license": "40387",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "423119",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Peoria, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.