Scott David Haferkamp, M.D.
Individual provider Active NPI Internal Medicine Physician · Phoenix, AZ
NPI 1497084479 · NPPES record last updated Mar 16, 2016
Key facts
- NPI
- 1497084479
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 46686 (AZ)
- Practice address
- 1300 N 12TH St
Suite 508
Phoenix, AZ 85006-2848 - Phone
- (602) 839-3927
- Fax
- (602) 839-4233
- NPI assigned
- Dec 21, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- University of Texas Southwestern Medical School at Dallas, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Banner - University Primary Care Physicians LLC
BHSM Rehabilitation LLC
Practice addresses (Care Compare)
1300 N 12TH St
Suite 508
Phoenix, AZ 85006-2849
Phone (602) 839-3927
25101 N Lake Pleasant Pkwy
Suite B 1340
Peoria, AZ 85383-1386
Phone (602) 610-6866
Hospital & facility affiliations
- Banner - University Medical Center Phoenix
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121205000293 | AZ | Practitioner - Internal Medicine | 1153573738 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P4058 | TX | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Banner -- University Primary Care Physicians LLC | Current |
Accepting new patients | |
| Banner - University Hospital Based Physicians LLC | Current |
Accepting new patients | |
| Banner - University Hospital Based Physicians LLC | Current |
Accepting new patients |
Locations
1459 S Higley Rd
Ste 106
Gilbert, AZ 85296
Phone (480) 543-6780
1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000
1300 N 12th St
Ste 500
Phoenix, AZ 85006
Phone (602) 839-2606
1300 N 12th St
Ste 508
Phoenix, AZ 85006
Phone (602) 839-3927
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 46686 | AZ | Yes |
| Internal Medicine Physician | 207R00000X | P4058 | TX |
Addresses
Primary practice location
1300 N 12TH St
Suite 508
Phoenix, AZ 85006-2848
Mailing address
1300 N 12TH St
Suite 508
Phoenix, AZ 85006-2848
Phone (602) 839-3927
Other providers in Phoenix, AZ
- Griffith Allen Haeggquist
- Kimberly E Haelen
- Charlton P Haerter
- Sonal P Haerter
- Charity Celeste Hafer
- Mohammed Hafiz
- Andre Daniel Hafner
- Christina Hagan
- Jonah Hagan
- Raquel Hagar
All providers in Phoenix, AZ · Internal Medicine Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 16, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.