Sultan Y Ayoub, FNP

Individual provider Active NPI Family Nurse Practitioner · Maricopa, AZ

NPI 1679803258 · NPPES record last updated Jul 14, 2023

Key facts

NPI
1679803258
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
AP3529 (AZ)
Practice address
21300 N John Wayne Pkwy Ste 112
Maricopa, AZ 85139-8964
Phone
(520) 568-9500
Fax
(520) 568-9533
NPI assigned
Jan 5, 2010
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

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.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sultan Y Ayoub FNP PLLC (2 clinicians)

Practice addresses (Care Compare)

21300 N John Wayne Pkwy
Suite 112
Maricopa, AZ 85139-8964
Phone (520) 568-9500

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20200404000481 AZ Practitioner - Nurse Practitioner 0840629358 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sultan Y Ayoub FNP PLLC Family Current
since Feb 29, 2020
Accepting new patients
Sultan Y. Ayoub FNP PLLC Family Past Accepting new patients

Locations

21300 N John Wayne Pkwy
Ste 112
Maricopa, AZ 85139
Phone (520) 381-3811

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP3529 AZ Yes

Addresses

Primary practice location

21300 N John Wayne Pkwy Ste 112
Maricopa, AZ 85139-8964

Mailing address

21300 N John Wayne Pkwy Ste 112
Maricopa, AZ 85139-8964
Phone (520) 568-9500

Other providers in Maricopa, AZ

All providers in Maricopa, AZ · Family Nurse Practitioner in Arizona

Sources for this page

Verify at the official NPI Registry.