Organization Active NPI

Cas Medical Center, LLC

  • Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1619489176
Registry record updated Oct 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP8549 Issued in AZ
Legal business name
CAS MEDICAL CENTER, LLC
Practice address
4619 N 24TH St
Phoenix, AZ 85016-5203
Phone
(602) 956-0111
Fax
(602) 956-6789
NPI assigned
Oct 24, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2017

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

Authorized official

Name
Vicki A Vega
Title
Manager
Phone
(602) 956-0111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X AP8549 AZ Primary

Addresses

Primary practice location

4619 N 24TH St
Phoenix, AZ 85016-5203

Mailing address

4619 N 24TH St
Phoenix, AZ 85016-5203
Phone (602) 956-0111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210921001039 AZ Part B Supplier - Clinic/Group Practice 3870990732 Receives reassigned benefits from 1 practitioner
Practice locations: Phoenix, AZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1508803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508803200000",
    "number": "1619489176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4619 N 24TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165203",
            "telephone_number": "602-956-0111",
            "fax_number": "602-956-6789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4619 N 24TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165203",
            "telephone_number": "602-956-0111",
            "fax_number": "602-956-6789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAS MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-24",
        "last_updated": "2017-10-24",
        "status": "A",
        "authorized_official_last_name": "VEGA",
        "authorized_official_first_name": "VICKI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "602-956-0111"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP8549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2017; 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.