Mdas LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

40747 Issued in AZ

Legal business name

MDAS LLC

Doing business as

MDS Family Practice

Practice address

10769 N Frank Lloyd Wright Blvd
A 120
Scottsdale, AZ 85259-2682

Phone

(480) 848-0991

Fax

(480) 452-0929

NPI assigned

Sep 27, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Marc D Sullivan, M.D.NPI 1437350030

Title

Owner

Phone

(480) 349-2886

Specialties & licenses 1

Addresses

Other names 1

• MDS Family Practice Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 2

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.

• Marc D Sullivan, M.D.

  • Family Medicine Physician
  • Fountain Hills, AZ
  • NPI 1437350030
  Medicare reassignment Authorized official
• Ashley Kelly, PA-C

  • Physician Assistant
  • Phoenix, AZ
  • NPI 1649754227
  Medicare reassignment

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

{
    "created_epoch": "1443312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443312000000",
    "number": "1801266333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10769 N FRANK LLOYD WRIGHT BLVD",
            "address_2": "A 120",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852592682",
            "telephone_number": "480-848-0991",
            "fax_number": "480-452-0929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10769 N FRANK LLOYD WRIGHT BLVD",
            "address_2": "A 120",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852592682",
            "telephone_number": "480-848-0991",
            "fax_number": "480-452-0929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-27",
        "last_updated": "2015-09-27",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-349-2886",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "40747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MDS Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• 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 Sep 27, 2015; 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.