Seth Alfred Fagerlie, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

33539 Issued in AZ

Practice address

5102 W Campbell Ave
Phoenix, AZ 85031-1703

Phone

(623) 848-5000

NPI assigned

Nov 7, 2005

Last updated

Nov 12, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Arizona Acute Medical Services 1 PC

  • Hospitalist Physician
  • Phoenix, AZ
  • NPI 1154860674
  Medicare reassignment NPD
• Emergency Group of Arizona Professional Corporation

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1215275433
  Medicare reassignment NPD
• Arizona Post-Acute Medical Services 1 PC

  • Hospitalist Physician
  • Phoenix, AZ
  • NPI 1093254419
  NPD (past)
• Emcare Physician Providers, Inc

  • Emergency Medicine Physician
  • Winslow, AZ
  • NPI 1144270315
  NPD (past)
• Emergency Physician Professional Association, LTD.

  • Emergency Medicine Physician
  • Glendale, AZ
  • NPI 1396769972
  NPD (past)
• Emergency Physicians Professional Association LTD

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1114931490
  NPD (past)
• Little Colorado Emergency Physicians LLC

  • Emergency Medicine Physician
  • Winslow, AZ
  • NPI 1457363418
  NPD (past)
• Team Physicians of Arizona PC

  • Emergency Medicine Physician
  • Mesa, AZ
  • NPI 1710915764
  NPD (past)
• Valley Emergency Physicians Inc

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1043224322
  NPD (past)
• Chase Dennis Emergency Medical Group Inc

  • Emergency Medicine Physician
  • Santa Rosa, CA
  • NPI 1033152350
  NPD (past)

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194825600000",
    "number": "1659352763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26078 N 71ST DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853837318",
            "telephone_number": "623-362-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5102 W CAMPBELL AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850311703",
            "telephone_number": "623-848-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGERLIE",
        "first_name": "SETH",
        "middle_name": "ALFRED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2007-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "33539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET GROUP",
            "identifier": "AW1436",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD GR",
            "identifier": "AZ0728670",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "936239",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE GROUP",
            "identifier": "39-81220",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jade Elise Fagan, PT
• Joseph Michael Fagan, LMSW
• Ibukun Ajoke Fagbuyi, PMHNP
• Sarita Fager, MA, LPC
• Chris David Fagerlie
• Mauhasin J Fagg-Daves
• Megan Kimi Fah, MD, MPH
• Shaghayegh Fahandez Sadi, DMD
• Sean Fahlgren, DPT
• Chloe Leslie Fahrberger, MS, BCBA

• Emergency Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Emergency Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.