Individual provider Active NPI

Shel-Don Legarreta, MD

  • Internal Medicine Physician
  • Tempe, AZ
National Provider Identifier
1902886377
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25100 Issued in AZ
Practice address
1920 E Baseline Rd
Tempe, AZ 85283-1511
Phone
(480) 345-5000
NPI assigned
Jan 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25100 AZ Primary

Addresses

Primary practice location

1920 E Baseline Rd
Tempe, AZ 85283-1511

Mailing address

1920 E Baseline Rd
Tempe, AZ 85283-1511
Phone (480) 345-5000

Other identifiers 1

IdentifierTypeStateIssuer
390203MedicaidAZ

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
I20050519000420 AZ Practitioner - Internal Medicine 2163463191

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cigna Health Care of Arizona Inc. Current Accepting new patients
Cigna Healthcare of Arizona, Inc. CurrentSince Aug 3, 2014 Accepting new patients
Cigna Health Care of Arizona Inc. Current Accepting new patients
Cigna Health Care of Arizona Inc. CurrentSince Aug 3, 2014 Accepting new patients

Locations

1717 W Chandler Blvd
Chandler, AZ 85224
Phone (480) 281-7565

1300 N 12th St
Ste 404
Phoenix, AZ 85006
Phone (602) 839-7000

8888 E Raintree Dr
Fl 3
Scottsdale, AZ 85260

13991 W Grand Ave
Ste 105
Surprise, AZ 85374
Phone (623) 455-7800

1920 E Baseline Rd
Tempe, AZ 85283
Phone (480) 345-5000

Organizations & group practices 4

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": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902886377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 E BASELINE RD",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852831511",
            "telephone_number": "480-345-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 E BASELINE RD",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852831511",
            "telephone_number": "480-345-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGARRETA",
        "first_name": "SHEL-DON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "25100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "390203",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

Verify at the official NPI Registry.