Active NPI
Sorin Rastau
- Assisted Living Facility
- Surprise, AZ
National Provider Identifier
1609172550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- AL8307H
- Practice address
- 16118 N 168TH LN
Surprise, AZ 85388-1350 - Phone
- (623) 328-9457
- Fax
- (623) 328-9457
- NPI assigned
- Feb 9, 2011
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | AL8307H | AZ | Primary |
Addresses
Primary practice location
16118 N 168TH LN
Surprise, AZ 85388-1350
Mailing address
16118 N 168TH LN
Surprise, AZ 85388-1350
Phone (623) 328-9457
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AL8307H | AZ | MD | Assisted Living Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297209600000",
"number": "1609172550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16118 N 168TH LN",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853881350",
"telephone_number": "623-328-9457",
"fax_number": "623-328-9457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16118 N 168TH LN",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853881350",
"telephone_number": "623-328-9457",
"fax_number": "623-328-9457"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RASTAU",
"first_name": "SORIN",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-02-09",
"last_updated": "2011-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "AZ",
"license": "AL8307H",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Surprise, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.