Individual provider Active NPI

Paul J Sos, MD

  • Family Medicine Physician
  • Scottsdale, AZ
National Provider Identifier
1437122553
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34548 Issued in AZ
Practice address
8575 E Princess Dr
Suite 117
Scottsdale, AZ 85255-5483
Phone
(480) 496-2696
Fax
(480) 264-7012
NPI assigned
Feb 9, 2006
Last updated
Jun 30, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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 34548 AZ Primary

Addresses

Primary practice location

8575 E Princess Dr
Suite 117
Scottsdale, AZ 85255-5483

Mailing address

8575 E Princess Dr
Suite 117
Scottsdale, AZ 85255-5483
Phone (480) 496-2696

Other identifiers 1

IdentifierTypeStateIssuer
965410MedicaidAZ

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
I20050928000063 AZ Practitioner - Family Practice 9234164336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optima Medical Care LLCGroup PAC ID 2062572563, 3 clinicians

Practice addresses (Care Compare)

8575 E Princess Dr
Suite 117
Scottsdale, AZ 85255-5437
Phone (480) 496-2696

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal774

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34548AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optima Medical Care, LLC CurrentSince Apr 27, 2009 Accepting new patients

Locations

485 S Dobson Rd
Ste 103
Chandler, AZ 85224
Phone (480) 963-2026

5505 W Chandler Blvd
Ste 11
Chandler, AZ 85226
Phone (480) 659-2571

9305 W Thomas Rd
Ste 490
Phoenix, AZ 85037
Phone (480) 496-2696

8575 E Princess Dr
Ste 117
Scottsdale, AZ 85255
Phone (480) 496-2696

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1437122553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8575 E PRINCESS DR",
            "address_2": "SUITE 117",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852555483",
            "telephone_number": "480-496-2696",
            "fax_number": "480-264-7012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8575 E PRINCESS DR",
            "address_2": "SUITE 117",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852555483",
            "telephone_number": "480-496-2696",
            "fax_number": "480-264-7012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOS",
        "first_name": "PAUL",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "34548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "965410",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.