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
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
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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sultan Y Ayoub FNP PLLC | Family | Current |
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.