Individual provider Active NPI

Justin Michael Hayden, DO

  • General Practice Physician
  • Sierra Vista, AZ
National Provider Identifier
1588305239
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
11060 Issued in AZ
Practice address
5700 E Highway 90
Sierra Vista, AZ 85635-9110
Phone
(520) 263-2000
NPI assigned
Apr 6, 2022
Last updated
Oct 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Physician 208D00000X 11060 AZ Primary

Addresses

Primary practice location

5700 E Highway 90
Sierra Vista, AZ 85635-9110

Mailing address

5700 E Highway 90
Sierra Vista, AZ 85635-9110

Other practice location 1

302 El Camino Real Bldg 11
Sierra Vista, AZ 85635-2860
Phone (520) 255-5475

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
I20241017003043 AZ Practitioner - General Practice 5698212090 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sound Physicians Emergency Medicine of Arizona IncGroup PAC ID 5799066650, 41 clinicians

Practice addresses (Care Compare)

5700 E Hwy 90
Sierra Vista, AZ 85635-9110
Phone (520) 417-4594

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11060AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffrey Wilde MD PLLC CurrentSince Aug 1, 2024 Accepting new patients
Sound Physicians Emergency Medicine of Arizona, Inc. CurrentSince Mar 20, 2025 Accepting new patients

Locations

1171 W Target Range Rd
Nogales, AZ 85621
Phone (520) 285-3000

302 El Camino Real
Bldg 11
Sierra Vista, AZ 85635
Phone (520) 204-1358

302 El Camino Real
Ste 11
Sierra Vista, AZ 85635
Phone (520) 255-5475

302 El Camino Real
Ste 11A
Sierra Vista, AZ 85635
Phone (520) 255-5475

5700 E Highway 90
Sierra Vista, AZ 85635
Phone (520) 263-2000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1649203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1588305239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 E HIGHWAY 90",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856359110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 E HIGHWAY 90",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856359110",
            "telephone_number": "520-263-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "302 El Camino Real Bldg 11",
            "address_purpose": "LOCATION",
            "city": "Sierra Vista",
            "state": "AZ",
            "postal_code": "856352860",
            "country_code": "US",
            "telephone_number": "520-255-5475",
            "fax_number": "855-801-7998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYDEN",
        "first_name": "JUSTIN",
        "middle_name": "MICHAEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-06",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AZ",
            "license": "11060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sierra Vista, AZ

Sources for this page

Verify at the official NPI Registry.