NPIMap

Organization Active NPI

Arizona Ear Nose and Throat Physicians PLLC

  • Speech/Language/Hearing Specialist/Technologist
  • Sun City West, AZ
National Provider Identifier
1730365958
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech/Language/Hearing Specialist/TechnologistTaxonomy code 235500000X
License
24954 Issued in AZ
Legal business name
ARIZONA EAR NOSE AND THROAT PHYSICIANS PLLC
Practice address
14510 W Shumway Dr Ste 101
Sun City West, AZ 85375-5815
Phone
(623) 975-1660
Fax
(623) 584-4282
NPI assigned
Jan 17, 2008
Last updated
Jan 23, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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

Authorized official

Name
Eleonora Kazimiera Tysiac
Title
Administrator
Phone
(623) 214-0308

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech/Language/Hearing Specialist/Technologist 235500000X 24954 AZ Primary

Addresses

Primary practice location

14510 W Shumway Dr Ste 101
Sun City West, AZ 85375-5815

Mailing address

14510 W Shumway Dr Ste 101
Sun City West, AZ 85375-5815
Phone (623) 975-1660

Other practice location 1

10503 W Thunderbird Blvd Ste 104
Sun City, AZ 85351-3047
Phone (623) 975-1660

Other identifiers 1

IdentifierTypeStateIssuer
40016859OtherAZRRB

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address contactus@az-ent.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040611001351 AZ Part B Supplier - Clinic/Group Practice 5698758357 Receives reassigned benefits from 6 practitioners
Practice locations: Sun City West, AZ

National Provider Directory

National Provider Directory

Locations

10503 W Thunderbird Blvd
Ste 104
Sun City, AZ 85351
Phone (623) 975-1660

14510 W Meeker Blvd
Sun City West, AZ 85375

14510 W Shumway Dr
Ste 101
Sun City West, AZ 85375
Phone (623) 544-7755

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1200528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674432000000",
    "number": "1730365958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14510 W SHUMWAY DR STE 101",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853755815",
            "telephone_number": "623-975-1660",
            "fax_number": "623-584-4282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14510 W SHUMWAY DR STE 101",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853755815",
            "telephone_number": "623-975-1660",
            "fax_number": "623-584-4282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10503 W Thunderbird Blvd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Sun City",
            "state": "AZ",
            "postal_code": "853513047",
            "country_code": "US",
            "telephone_number": "623-975-1660",
            "fax_number": "623-975-1654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ARIZONA EAR NOSE AND THROAT PHYSICIANS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-17",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A",
        "authorized_official_last_name": "TYSIAC",
        "authorized_official_first_name": "ELEONORA",
        "authorized_official_middle_name": "KAZIMIERA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "623-214-0308"
    },
    "taxonomies": [
        {
            "code": "235500000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist",
            "state": "AZ",
            "license": "24954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRB",
            "identifier": "40016859",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "contactus@az-ent.com",
            "affiliation": "N",
            "endpointDescription": "patient fax server",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "14510 W Shumway Dr Ste 101",
            "city": "Sun City West",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853755815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sun City West, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; 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.