Ivy League Anesthesia PLLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

IVY LEAGUE ANESTHESIA PLLC

Practice address

7878 N 16TH St Ste 250
Phoenix, AZ 85020-4478

Phone

(602) 308-7802

NPI assigned

Nov 6, 2018

Last updated

Nov 6, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sameh Assad, MD

Title

Sole Member

Phone

(602) 405-9985

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1541462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541462400000",
    "number": "1346718582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7878 N 16TH ST STE 250",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204478",
            "telephone_number": "602-308-7802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7878 N 16TH ST STE 250",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204478",
            "telephone_number": "602-308-7802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVY LEAGUE ANESTHESIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-06",
        "last_updated": "2018-11-06",
        "status": "A",
        "authorized_official_last_name": "ASSAD",
        "authorized_official_first_name": "SAMEH",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "602-405-9985",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "943622",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Anesthesiology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.