Individual provider Active NPI

Ahsan Shahid Kamal

  • Student in an Organized Health Care Education/Training Program
  • Phoenix, AZ
National Provider Identifier
1306465646
Registry record updated Apr 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1111 E McDowell Rd
Phoenix, AZ 85006-2612
Phone
(602) 839-2000
NPI assigned
Apr 15, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1111 E McDowell Rd
Phoenix, AZ 85006-2612

Mailing address

1111 E McDowell Rd
Phoenix, AZ 85006-2612

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230630000361 AZ Practitioner - Internal Medicine 4981027034 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Banner - University Hospital Based Physicians LLC CurrentSince Jun 21, 2023 Accepting new patients
Banner Hospital Based Physicians Arizona LLC Current Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Feb 4, 2024 Accepting new patients
Banner - University Hospital Based Physicians LLC CurrentSince Jun 21, 2023 Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Feb 4, 2024 Accepting new patients
Banner -- University Primary Care Physicians LLC CurrentSince Jun 21, 2023 Accepting new patients

Locations

1900 N Higley Rd
Gilbert, AZ 85234
Phone (480) 543-2000

1300 N 12th St
Ste 500
Phoenix, AZ 85006
Phone (602) 839-2606

1300 N 12th St
Ste 508
Phoenix, AZ 85006
Phone (602) 839-3927

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

Organizations & group practices 6

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": "1586908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586908800000",
    "number": "1306465646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 E MCDOWELL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 E MCDOWELL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062612",
            "telephone_number": "602-839-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMAL",
        "first_name": "AHSAN",
        "middle_name": "SHAHID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-15",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.