Individual provider Active NPI

Sean C Reeder, DO

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1437115599
Registry record updated Nov 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3530 Issued in AZ
Practice address
3933 E Edna Ave
Suite 101
Phoenix, AZ 85032-2127
Phone
(602) 867-2219
Fax
(602) 867-1637
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3530 AZ Primary

Addresses

Primary practice location

3933 E Edna Ave
Suite 101
Phoenix, AZ 85032-2127

Mailing address

3933 E Edna Ave
Suite 101
Phoenix, AZ 85032-2127
Phone (602) 867-2219

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
I20051201000316 AZ Practitioner - Family PracticePractitioner - Other (Physician) 8325068604 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwestern UniversityGroup PAC ID 6305734773, 116 clinicians

Practice addresses (Care Compare)

19389 N 59TH Ave
Glendale, AZ 85308-6500
Phone (623) 537-6000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Midwestern University CurrentSince Jan 1, 2013 Accepting new patients
Midwestern University Current Accepting new patients
Midwestern University CurrentSince Jan 1, 2013 Accepting new patients

Locations

19389 N 59th Ave
Glendale, AZ 85308

26520 Network Pl
Chicago, IL 60673
Phone (630) 743-4500

Interoperability endpoints

  • Direct secure messaging: sreeder19790@direct.midwestern.edu

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354147200000",
    "number": "1437115599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3933 E EDNA AVE",
            "address_2": "SUITE 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322127",
            "telephone_number": "602-867-2219",
            "fax_number": "602-867-1637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3933 E EDNA AVE",
            "address_2": "SUITE 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322127",
            "telephone_number": "602-867-2219",
            "fax_number": "602-867-1637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEDER",
        "first_name": "SEAN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2012-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "3530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.