Ken Shadman Ota, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5305 Issued in AZ

Practice address

9821 N 95TH St Ste 101
Scottsdale, AZ 85258-4589

Phone

(480) 365-8035

NPI assigned

Jul 3, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Family Practice

Education

Other, 2008

Medicare assignment

May accept Medicare assignment

Group practices

Aligned Medical Providers LLCGroup PAC ID 9234553116, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Boswell Medical Center Hospital, Sun City, AZ, CCN 030061
• Banner Thunderbird Medical Center Hospital, Glendale, AZ, CCN 030089
• Banner Desert Medical Center Hospital, Mesa, AZ, CCN 030065
• Banner - University Medical Center Phoenix Hospital, Phoenix, AZ, CCN 030002
• Banner - University Medical Center Tucson Campus Hospital, Tucson, AZ, CCN 030064

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Aligned Medical Providers, LLC

  • Family Medicine Physician
  • Scottsdale, AZ
  • NPI 1386267078
  Medicare reassignment Care Compare group NPD Authorized official
• Scottsdale Physicians Group PLC

  • Internal Medicine Physician
  • Scottsdale, AZ
  • NPI 1689799579
  Medicare reassignment NPD
• Center for Physical Medicine & Rehabilitation P C

  • Physical Medicine & Rehabilitation Physician
  • Phoenix, AZ
  • NPI 1306959218
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Banner - University Medical Center Phoenix

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1841224870
  Care Compare affiliation
• Banner - University Medical Center Tucson Campus LLC

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1265820179
  Care Compare affiliation
• Banner - University Medical Center Tucson Campus LLC

  • Nutrition Education Nutritionist
  • Tucson, AZ
  • NPI 1861102881

  Hospital

  Care Compare affiliation
• Banner Boswell Medical Center

  • General Acute Care Hospital
  • Sun City, AZ
  • NPI 1952560914
  Care Compare affiliation
• Banner Desert Medical Center

  • General Acute Care Hospital
  • Mesa, AZ
  • NPI 1720011810
  Care Compare affiliation
• Banner Thunderbird Medical Center

  • General Acute Care Hospital
  • Glendale, AZ
  • NPI 1154355188
  Care Compare affiliation

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574380800000",
    "number": "1750544276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9821 N 95TH ST STE 101",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584589",
            "telephone_number": "480-365-8035",
            "fax_number": "480-718-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9821 N 95TH ST STE 101",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584589",
            "telephone_number": "480-365-8035"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7975 N Hayden Rd Ste D354",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852583243",
            "country_code": "US",
            "telephone_number": "480-268-2670",
            "fax_number": "480-268-2671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTA",
        "first_name": "KEN",
        "middle_name": "SHADMAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-03",
        "last_updated": "2019-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "5305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Oswald
• Kayla Oswald
• Wolfgang Ja Oswald, PT
• Bradley O Oswood, MD
• Ota Ventures LLC
• Jenny Otalvaro
• Princess Adjoa Oteng, NP
• Tiffany Maiva Nguyen Otero, MD
• Otpp Ventures LLC
• Jennifer L Otterbein, RN, CNP

• Family Medicine Physician in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.