Individual provider Active NPI

Sara Velazquez Kertz, D.O.

  • Pediatrics Physician
  • Scottsdale, AZ
National Provider Identifier
1891732129
Registry record updated Sep 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
3800 Issued in AZ
Practice address
4848 E Cactus Rd
#620
Scottsdale, AZ 85254-4163
Phone
(602) 996-0190
Fax
(602) 996-5516
NPI assigned
Jun 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 3800 AZ Primary

Addresses

Primary practice location

4848 E Cactus Rd
#620
Scottsdale, AZ 85254-4163

Mailing address

4848 E Cactus Rd
#620
Scottsdale, AZ 85254-4163
Phone (602) 996-0190

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210412000248 AZ Practitioner - Pediatric Medicine 6608284781 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
3800AZMDVeterinarian

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Children'S Medical Group CurrentSince Apr 1, 2021 Accepting new patients
Phoenix Children'S Hospital Pediatrics Current Accepting new patients
Phoenix Children'S Medical Group CurrentSince Apr 1, 2021 Accepting new patients

Locations

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

3200 E Camelback Rd
Ste 250
Phoenix, AZ 85018
Phone (602) 933-1814

4848 E Cactus Rd
Ste 620
Scottsdale, AZ 85254
Phone (602) 386-2135

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348531200000",
    "number": "1891732129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4848 E CACTUS RD",
            "address_2": "#620",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852544163",
            "telephone_number": "602-996-0190",
            "fax_number": "602-996-5516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4848 E CACTUS RD",
            "address_2": "#620",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852544163",
            "telephone_number": "602-996-0190",
            "fax_number": "602-996-5516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERTZ",
        "first_name": "SARA",
        "middle_name": "VELAZQUEZ",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2012-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "3800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.