NPIMap

Organization Active NPI

Senior Doc Arizona PC

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1700477627
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SENIOR DOC ARIZONA PC
Practice address
14631 N Cave Creek Rd Ste 104
Phoenix, AZ 85022-4100
Phone
(855) 434-7763
Fax
(949) 281-5550
NPI assigned
Feb 2, 2021
Last updated
Mar 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Authorized official

Name
Angelica Leyla Soto
Title
Credentialing Specialist
Phone
(855) 434-7763

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

14631 N Cave Creek Rd Ste 104
Phoenix, AZ 85022-4100

Mailing address

5 Hutton Centre Dr Ste 950
Santa Ana, CA 92707-8714
Phone (855) 434-7763

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, AZ, ID, OR4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20210316002655 CA Part B Supplier - Clinic/Group Practice 6103232111 Receives reassigned benefits from 1 practitioner
Practice locations: Santa Ana, CA
O20211104002828 AZ Part B Supplier - Clinic/Group Practice 6103232111 Receives reassigned benefits from 34 practitioners
Practice locations: Phoenix, AZ
O20260602003788 ID Part B Supplier - Clinic/Group Practice 6103232111 Receives reassigned benefits from 3 practitioners
Practice locations: Nampa, ID
O20260610000952 OR Part B Supplier - Clinic/Group Practice 6103232111 Receives reassigned benefits from 3 practitioners
Practice locations: Ontario, OR

National Provider Directory

National Provider Directory

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

7727 W Deer Valley Rd
Ste 215
Peoria, AZ 85382
Phone (623) 404-2244

Practitioners & affiliated clinicians

Practitioners 38

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1612224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743033600000",
    "number": "1700477627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 HUTTON CENTRE DR STE 950",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927078714",
            "telephone_number": "855-434-7763",
            "fax_number": "949-281-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14631 N CAVE CREEK RD STE 104",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850224100",
            "telephone_number": "855-434-7763",
            "fax_number": "949-281-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR DOC ARIZONA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-02",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A",
        "authorized_official_last_name": "SOTO",
        "authorized_official_first_name": "ANGELICA",
        "authorized_official_middle_name": "LEYLA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "855-434-7763"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.