Individual provider Active NPI

Sarah E Wicklund, M.D.

  • Psychiatry Physician
  • Scottsdale, AZ
National Provider Identifier
1629241179
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
45661 Issued in AZ
Practice address
8585 E Hartford Dr Ste 103
Scottsdale, AZ 85255-5472
Phone
(480) 562-6600
Fax
(480) 562-6606
NPI assigned
Apr 4, 2008
Last updated
Apr 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 45661 AZ Primary

Addresses

Primary practice location

8585 E Hartford Dr Ste 103
Scottsdale, AZ 85255-5472

Mailing address

PO Box 11616
Glendale, AZ 85318-1616
Phone (480) 562-6600

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
I20120810000260 AZ Practitioner - Psychiatry 1850424425 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mindfully Integrated Health PLLCGroup PAC ID 7113275397, 3 clinicians

Practice addresses (Care Compare)

8585 E Hartford Dr
Suite 103
Scottsdale, AZ 85255-5472
Phone (480) 562-6600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45661AZMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mindfully Integrated Health PLLC Psychiatry CurrentSince Jul 1, 2018 Accepting new patients

Locations

8585 E Hartford Dr
Ste 103
Scottsdale, AZ 85255
Phone (480) 248-7231

8585 E Hartford Dr
Ste 400
Scottsdale, AZ 85255
Phone (480) 454-5598

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

NPI Registry JSON

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

{
    "created_epoch": "1207267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1629241179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11616",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853181616",
            "telephone_number": "480-562-6600",
            "fax_number": "480-562-6606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8585 E HARTFORD DR STE 103",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852555472",
            "telephone_number": "480-562-6600",
            "fax_number": "480-562-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKLUND",
        "first_name": "SARAH",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-04",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "45661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.