Individual provider Active NPI

Mona Fouad Elsakka, MD

  • Student in an Organized Health Care Education/Training Program
  • Phoenix, AZ
National Provider Identifier
1497077507
Registry record updated May 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
0115 Issued in NM
Practice address
350 W Thomas Rd
Attn: Academic Affairs
Phoenix, AZ 85013-4409
Phone
(602) 406-3538
NPI assigned
Feb 17, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X R71391 AZ
Student in an Organized Health Care Education/Training Program 390200000X 0115 NM Primary

Addresses

Primary practice location

350 W Thomas Rd
Attn: Academic Affairs
Phoenix, AZ 85013-4409

Mailing address

350 W. Thomas LRD
Attn: Academic Affairs
Phoenix, AZ 85013
Phone (602) 406-3538

Other identifiers 1

IdentifierTypeStateIssuer
R71391OtherAZTRAINING PERMIT

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R71391AZMDAnatomic Pathology & Clinical Pathology Physician
0115NMMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1266364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367452800000",
    "number": "1497077507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 W. THOMAS LRD",
            "address_2": "ATTN: ACADEMIC AFFAIRS",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85013",
            "telephone_number": "602-406-3538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W THOMAS RD",
            "address_2": "ATTN: ACADEMIC AFFAIRS",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134409",
            "telephone_number": "602-406-3538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELSAKKA",
        "first_name": "MONA",
        "middle_name": "FOUAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-17",
        "last_updated": "2013-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AZ",
            "license": "R71391",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": "0115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAINING PERMIT",
            "identifier": "R71391",
            "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 May 2, 2013; 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.