Individual provider Active NPI

Linda Ivana Sodoma, D.O.

  • Obstetrics & Gynecology Physician
  • Gilbert, AZ
National Provider Identifier
1669448577
Registry record updated Mar 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
3413 Issued in AZ
Practice address
4001 E Baseline Rd Ste 208
Gilbert, AZ 85234-2743
Phone
(480) 668-4411
Fax
(480) 776-5169
NPI assigned
Feb 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 3413 AZ Primary

Addresses

Primary practice location

4001 E Baseline Rd Ste 208
Gilbert, AZ 85234-2743

Mailing address

4001 E Baseline Rd Ste 208
Gilbert, AZ 85234-2743
Phone (480) 668-4411

Other identifiers 1

IdentifierTypeStateIssuer
470386MedicaidAZ

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
I20041020001143 AZ Practitioner - Obstetrics/Gynecology 0840275434 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
New York College of Osteo Medicine of New York Institute of Technology, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4001 E Baseline Rd
Suite 208
Gilbert, AZ 85234-2743
Phone 4806684411684411

Hospital & facility affiliations

  • Banner Gateway Medical Center Hospital, Gilbert, AZ, CCN 030122

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3413AZMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Linda I. Sodoma DO PLC Gynecology CurrentSince Jan 1, 2003 Accepting new patients

Locations

3921 E Baseline Rd
Ste 10
Gilbert, AZ 85234

4001 E Baseline Rd
Ste 208
Gilbert, AZ 85234
Phone (480) 668-4411

3921 E Baseline Rd
Ste 100
Gilbert, AZ 85234
Phone (480) 289-5252

6844 E Brown Rd
Ste 101
Mesa, AZ 85207
Phone (480) 832-5500

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 1

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": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1669448577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 E BASELINE RD STE 208",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342743",
            "telephone_number": "480-668-4411",
            "fax_number": "480-776-5169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 E BASELINE RD STE 208",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342743",
            "telephone_number": "480-668-4411",
            "fax_number": "480-776-5169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SODOMA",
        "first_name": "LINDA",
        "middle_name": "IVANA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "3413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "470386",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.