Individual provider Active NPI

Vidushi Soni, MD

  • Internal Medicine Physician
  • Sun City, AZ
National Provider Identifier
1306924246
Registry record updated Mar 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
27870 Issued in AZ
Practice address
14815 N del Webb Blvd
Sun City, AZ 85345
Phone
(623) 977-3300
Fax
(623) 977-6808
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 27870 AZ Primary

Addresses

Primary practice location

14815 N del Webb Blvd
Sun City, AZ 85345

Mailing address

14815 N del Webb Blvd
Sun City, AZ 85345
Phone (623) 977-3300

Other identifiers 4

IdentifierTypeStateIssuer
Z69231OtherAZMEDICARE
110235115OtherRAILROAD MEDICARE
560848MedicaidAZ
0896550OtherAZBLUE CROSS

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
I20110221000125 AZ Practitioner - Internal Medicine 6800076381 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27870AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centerwell Senior Primary Care Az PC Internal Medicine Past Accepting new patients
Centerwell Senior Primary Care Az PC Internal Medicine Past Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Destiny Springs Healthcare LLCSurprise, AZ, CCN 034034 Hospital 5% Or Greater Direct Ownership Interest (100%)
General Partnership Interest (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Nov 30, 2020
Nov 30, 2020
Nov 30, 2020
Nov 30, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299628800000",
    "number": "1306924246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14815 N DEL WEBB BLVD",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "85345",
            "telephone_number": "623-977-3300",
            "fax_number": "623-977-6808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14815 N DEL WEBB BLVD",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "85345",
            "telephone_number": "623-977-3300",
            "fax_number": "623-977-6808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONI",
        "first_name": "VIDUSHI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2011-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "27870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "Z69231",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110235115",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "560848",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0896550",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City, AZ

Sources for this page

Verify at the official NPI Registry.