NPIMap

Organization Active NPI

4C Medical Group PLC

  • Multi-Specialty Clinic/Center
  • Scottsdale, AZ
National Provider Identifier
1558654384
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
4C MEDICAL GROUP PLC
Practice address
9590 E Ironwood Square Dr Ste 125
Scottsdale, AZ 85258-4583
Phone
(480) 455-3000
Fax
(866) 819-6115
NPI assigned
May 26, 2011
Last updated
Jul 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Authorized official

Name
Emily Castillo
Title
Medical Staff Manager
Phone
(702) 480-2550

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU
Hospitalist Physician 208M00000X NU

Addresses

Primary practice location

9590 E Ironwood Square Dr Ste 125
Scottsdale, AZ 85258-4583

Mailing address

9590 E Ironwood Square Dr Ste 125
Scottsdale, AZ 85258-4583
Phone (480) 455-3000

Other identifiers 1

IdentifierTypeStateIssuer
625202MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110926000641 AZ Part B Supplier - Clinic/Group Practice 2769653641 Receives reassigned benefits from 128 practitioners
1 other NPI on this enrollment
Practice locations: Phoenix, AZ; San Tan Valley, AZ; Scottsdale, AZ; Sun City, AZ; Surprise, AZ; Mesa, AZ; Carefree, AZ; Chandler, AZ…

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

36889 N Tom Darlington Dr
#A4
Carefree, AZ 85377
Phone (480) 488-9220

3420 S Mercy Rd
Ste 101
Gilbert, AZ 85297
Phone (480) 821-3800

3090 N Litchfield Rd
Ste 120
Goodyear, AZ 85395
Phone (602) 843-8426

4110 N 108th Ave
Phoenix, AZ 85037

4845 E Thunderbird Rd
Ste 1
Scottsdale, AZ 85254
Phone (480) 699-7004

9590 E Ironwood Square Dr
Ste 112
Scottsdale, AZ 85258

14811 W Bell Rd
Ste 100
Surprise, AZ 85374
Phone (623) 328-7323

15021 W Bell Rd
Ste 125
Surprise, AZ 85374
Phone (623) 476-7880

Practitioners & affiliated clinicians

Practitioners 168

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 168

NPI Registry JSON

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

{
    "created_epoch": "1306368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690761600000",
    "number": "1558654384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9590 E IRONWOOD SQUARE DR STE 125",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584583",
            "telephone_number": "480-455-3000",
            "fax_number": "866-819-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9590 E IRONWOOD SQUARE DR STE 125",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584583",
            "telephone_number": "480-455-3000",
            "fax_number": "866-819-6115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "4C MEDICAL GROUP PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-26",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A",
        "authorized_official_last_name": "CASTILLO",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "MEDICAL STAFF MANAGER",
        "authorized_official_telephone_number": "702-480-2550"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "625202",
            "state": "AZ"
        }
    ],
    "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 Jul 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.