Individual provider Active NPI

Justin Seroy, D.O.

  • Infectious Disease Physician
  • Phoenix, AZ
National Provider Identifier
1528374303
Registry record updated Aug 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
006635 Issued in AZ
Practice address
650 E Indian School Rd
Phoenix, AZ 85012-1839
Phone
(602) 277-5551
Fax
(602) 200-6034
NPI assigned
Aug 31, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 036.132166 IL
Student in an Organized Health Care Education/Training Program 390200000X 125057500 IL
Infectious Disease Physician 207RI0200X 006635 AZ Primary

Addresses

Primary practice location

650 E Indian School Rd
Phoenix, AZ 85012-1839

Mailing address

650 E Indian School Rd
Phoenix, AZ 85012-1839
Phone (602) 277-5551

Other identifiers 1

IdentifierTypeStateIssuer
125057500OtherILSTATE LICENSE

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
I20150717001546 AZ Practitioner - Infectious DiseasePractitioner - Internal Medicine 8921252115 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arizona Infectious Disease PLLCGroup PAC ID 9133460694, 6 clinicians

Practice addresses (Care Compare)

5601 W Eugie Ave
Suite 204
Glendale, AZ 85304-1258
Phone (623) 244-0050

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.65 of 100Reported as group
Quality
86.26
Promoting interoperability
100
Improvement activities
40
Cost
74.31

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.132166ILMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Infectious Disease PLLC Infectious Disease CurrentSince Jul 18, 2024 Accepting new patients

Locations

5601 W Eugie Ave
Ste 204
Glendale, AZ 85304
Phone (623) 244-0050

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

2899 N 87th St
Ste 110
Scottsdale, AZ 85257
Phone (480) 582-3700

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24976/brand/1/csg/1/fhir/r4
  • Direct secure messaging: justin.seroy.1@24976.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1283212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566518400000",
    "number": "1528374303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 E INDIAN SCHOOL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121839",
            "telephone_number": "602-277-5551",
            "fax_number": "602-200-6034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 E INDIAN SCHOOL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121839",
            "telephone_number": "602-277-5551",
            "fax_number": "602-200-6034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEROY",
        "first_name": "JUSTIN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-31",
        "last_updated": "2019-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "IL",
            "license": "036.132166",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125057500",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "AZ",
            "license": "006635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "125057500",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.