Active NPI
Emmanuel Siaw, MD
- Pediatric Gastroenterology Physician
- Phoenix, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Gastroenterology Physician
- License
- 36040
- Practice address
- 1919 E Thomas Rd
Phoenix, AZ 85016-7710 - Phone
- (602) 933-0940
- Fax
- (602) 933-2424
- NPI assigned
- Sep 25, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Gastroenterology Physician | 2080P0206X | E-2529 | AR | |
| Pediatric Gastroenterology Physician | 2080P0206X | 36040 | AZ | Primary |
Addresses
Primary practice location
1919 E Thomas Rd
Phoenix, AZ 85016-7710
Mailing address
3200 E Camelback Rd Ste 250
Phoenix, AZ 85018-2327
Phone (602) 933-1814
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 370016472 | Other | AR | RAILROAD MEDICARE |
| 148768 | Medicaid | AZ | |
| 140189001 | Medicaid | AR |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Gastroenterology
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1665 N Avondale Blvd
Avondale, AZ 85392-5006
Phone (602) 933-0930
1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone (602) 933-0930
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Phoenix Children'S Hospital | Current | Accepting new patients | |
| Phoenix Children'S Medical Group | Current | Accepting new patients |
Locations
1665 N Avondale Blvd
Avondale, AZ 85392
Phone (602) 933-0005
1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777
1919 E Thomas Rd
Fl 2
Phoenix, AZ 85016
Phone (602) 933-3033
3200 E Camelback Rd
Ste 250
Phoenix, AZ 85018
Phone (602) 933-1814
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.
-
- Pediatrics Physician
- Phoenix, AZ
- NPI 1922112044
-
- Multi-Specialty Clinic/Center
- Mesa, AZ
- NPI 1487814240
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522108800000",
"number": "1326148602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 E CAMELBACK RD STE 250",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850182327",
"telephone_number": "602-933-1814"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1919 E THOMAS RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850167710",
"telephone_number": "602-933-0940",
"fax_number": "602-933-2424"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIAW",
"first_name": "EMMANUEL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-25",
"last_updated": "2018-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "AR",
"license": "E-2529",
"primary": false
},
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "AZ",
"license": "36040",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "370016472",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "148768",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "140189001",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.