Active NPI
Sara E Medunick, DO
- Family Medicine Physician
- Scottsdale, AZ
National Provider Identifier
1497742761
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 25MB07846300
- Practice address
- 11058 E Raintree Dr
Scottsdale, AZ 85255-1809 - Phone
- (610) 509-5115
- NPI assigned
- Oct 3, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 25MB07846300 | NJ | Primary |
Addresses
Primary practice location
11058 E Raintree Dr
Scottsdale, AZ 85255-1809
Mailing address
11058 E Raintree Dr
Scottsdale, AZ 85255-1809
Phone (610) 509-5115
Other practice location 1
5 Eisenhower Rd
Columbia, NJ 07832-2716
Phone (908) 362-5360
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0072796 | Medicaid | NJ |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MB07846300 | NJ | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michael Karagas, M.D., P.C. D/B/a/ KMG Medical Group | Family Medicine | Past | Accepting new patients |
| Highlands Interventional Pain Management LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Pain Medicine (Anesthesiology) Physician
- Newton, NJ
- NPI 1528164258
-
- Family Medicine Physician
- San Francisco, CA
- NPI 1740788702
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661212800000",
"number": "1497742761",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11058 E RAINTREE DR",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852551809",
"telephone_number": "610-509-5115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11058 E RAINTREE DR",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852551809",
"telephone_number": "610-509-5115"
}
],
"practiceLocations": [
{
"address_1": "5 Eisenhower Rd",
"address_purpose": "LOCATION",
"city": "Columbia",
"state": "NJ",
"postal_code": "078322716",
"country_code": "US",
"telephone_number": "908-362-5360",
"fax_number": "908-362-8396",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MEDUNICK",
"first_name": "SARA",
"middle_name": "E",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-10-03",
"last_updated": "2022-08-23",
"certification_date": "2022-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NJ",
"license": "25MB07846300",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0072796",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Scottsdale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.