NPIMap

Individual provider Active NPI

Jeffrey A Laiserin, M.D.

  • Nephrology Physician
  • Phoenix, AZ
National Provider Identifier
1902892433
Registry record updated Jun 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
29687 Issued in AZ
Practice address
337 E Coronado Rd
Suite 201
Phoenix, AZ 85004-1580
Phone
(602) 252-8081
Fax
(602) 252-1520
NPI assigned
Sep 20, 2005
Last updated
Jun 19, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 29687 AZ Primary

Addresses

Primary practice location

337 E Coronado Rd
Suite 201
Phoenix, AZ 85004-1580

Mailing address

2149 E Warner Rd
Suite 101
Tempe, AZ 85284-3494
Phone (480) 610-6100

Other identifiers 1

IdentifierTypeStateIssuer
596736MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050822001394 AZ Practitioner - NephrologyPractitioner - Internal Medicine 0345142642 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
State University of Ny Upstate Medical University, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southwest Kidney Institute PLCGroup PAC ID 8224930987, 100 clinicians

Practice addresses (Care Compare)

2610 N 3Rd St
Phoenix, AZ 85004-1102
Phone (480) 610-6100

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Kidney Institute Scottsdale LLC Nephrology CurrentSince Jan 27, 2014 Accepting new patients

Locations

337 E Coronado Rd
Ste 201
Phoenix, AZ 85004
Phone (602) 252-8081

2149 E Warner Rd
Ste 101
Tempe, AZ 85284
Phone (480) 610-6111

2149 E Warner Rd
Ste 102
Tempe, AZ 85284
Phone (623) 247-0808

Interoperability endpoints

  • Direct secure messaging: jeffrey.laiserin.1@2697.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340064000000",
    "number": "1902892433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2149 E WARNER RD",
            "address_2": "SUITE 101",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852843494",
            "telephone_number": "480-610-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "337 E CORONADO RD",
            "address_2": "SUITE 201",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041580",
            "telephone_number": "602-252-8081",
            "fax_number": "602-252-1520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAISERIN",
        "first_name": "JEFFREY",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2012-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AZ",
            "license": "29687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "596736",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.