Individual provider Active NPI

Filip Variciuc

  • Assisted Living Facility
  • Glendale, AZ
National Provider Identifier
1811698335
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL8104H Issued in AZ
Practice address
19728 N 79TH Ave
Glendale, AZ 85308-6150
Phone
(708) 612-1497
NPI assigned
Mar 13, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL8104H AZ Primary

Addresses

Primary practice location

19728 N 79TH Ave
Glendale, AZ 85308-6150

Mailing address

19728 N 79TH Ave
Glendale, AZ 85308-6150
Phone (708) 612-1497

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AL8104HAZMDAssisted Living Facility

NPI Registry JSON

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

{
    "created_epoch": "1678665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1811698335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19728 N 79TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086150",
            "telephone_number": "708-612-1497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19728 N 79TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086150",
            "telephone_number": "708-612-1497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARICIUC",
        "first_name": "FILIP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-13",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "AL8104H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.