Active NPI
Samson Gary Serbin, M.D.
- Surgery of the Hand (Surgery) Physician
- Phoenix, AZ
National Provider Identifier
1326151028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery of the Hand (Surgery) Physician
- License
- 17526
- Practice address
- 6036 North 19TH Avenue
Suite 400B
Phoenix, AZ 85015-2110 - Phone
- (602) 242-2520
- Fax
- (602) 242-7625
- NPI assigned
- Aug 16, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery of the Hand (Surgery) Physician | 2086S0105X | 17526 | AZ | Primary |
Addresses
Primary practice location
6036 North 19TH Avenue
Suite 400B
Phoenix, AZ 85015-2110
Mailing address
6036 North 19TH Avenue
Suite 400B
Phoenix, AZ 85015-2110
Phone (602) 242-2520
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 122502 | Other | AZ | HEALTHNET |
| 3354946 | Other | AZ | CIGNA |
| 299124-01 | Medicaid | AZ | |
| 4062898 | Other | AZ | AETNA |
| AZ0258960 | Other | AZ | BLUE CROSS |
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 |
|---|---|---|---|
| 17526 | AZ | MD | Surgery of the Hand (Surgery) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1326151028",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6036 NORTH 19TH AVENUE",
"address_2": "SUITE 400B",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850152110",
"telephone_number": "602-242-2520",
"fax_number": "602-242-7625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6036 NORTH 19TH AVENUE",
"address_2": "SUITE 400B",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850152110",
"telephone_number": "602-242-2520",
"fax_number": "602-242-7625"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERBIN",
"first_name": "SAMSON",
"middle_name": "GARY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0105X",
"taxonomy_group": "",
"desc": "Surgery, Surgery of the Hand",
"state": "AZ",
"license": "17526",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET",
"identifier": "122502",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "3354946",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "299124-01",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4062898",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "AZ0258960",
"state": "AZ"
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.