Individual provider Active NPI

Samuel Nelson Sigoloff, D.O.

  • Family Medicine Physician
  • Sierra Vista, AZ
National Provider Identifier
1629486154
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
010671 Issued in AZ
Practice address
4990 E Mediterranean Dr
Sierra Vista, AZ 85635-2494
Phone
(520) 439-5186
NPI assigned
Jul 29, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1149 NE
Family Medicine Physician 207Q00000X S3747 TX
Family Medicine Physician 207Q00000X 010671 AZ Primary

Addresses

Primary practice location

4990 E Mediterranean Dr
Sierra Vista, AZ 85635-2494

Mailing address

4990 E Mediterranean Dr
Sierra Vista, AZ 85635-2494
Phone (520) 439-5186

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
I20231106003374 AZ Practitioner - General PracticePractitioner - Family Practice 5092162560 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Ohio University, College of Osteopathic Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carnett Clinic LLCGroup PAC ID 5890732655, 6 clinicians

Practice addresses (Care Compare)

4990 E Mediterranean Dr
Suite a
Sierra Vista, AZ 85635-2495
Phone (520) 439-5186

Hospital & facility affiliations

  • Bayada Home Health Care, Inc Home health agency, Sierra Vista, AZ, CCN 037416
  • Canyon Vista Medical Center Hospital, Sierra Vista, AZ, CCN 030043
  • Tucson Medical Center Hospital, Tucson, AZ, CCN 030006

Merit-based Incentive Payment System (MIPS)

Final score
14.73 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
49.1

Merit-based Incentive Payment System (MIPS)

Final score
91.52 of 100Reported as group
Quality
100
Improvement activities
40
Cost
71.74

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S3747TXMDFamily Medicine Physician
1149NEMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carnett Clinic, LLC CurrentSince Jan 2, 2024 Accepting new patients

Locations

4990 E Mediterranean Dr
Ste A
Sierra Vista, AZ 85635
Phone (520) 439-5186

4990 E Mediterranean Dr
Sierra Vista, AZ 85635
Phone (520) 417-1163

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1406592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1629486154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4990 E MEDITERRANEAN DR",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352494",
            "telephone_number": "520-439-5186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4990 E MEDITERRANEAN DR",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352494",
            "telephone_number": "520-439-5186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIGOLOFF",
        "first_name": "SAMUEL",
        "middle_name": "NELSON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-29",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "1149",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "S3747",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "010671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sierra Vista, AZ

Sources for this page

Verify at the official NPI Registry.