Active NPI
Jeffrey M Sanwick, MD
- Specialist
- Prescott, AZ
National Provider Identifier
1952339723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 24728
- Practice address
- 811 Ainsworth Dr
Suite 101
Prescott, AZ 86301-1687 - Phone
- (928) 771-5282
- Fax
- (928) 771-5283
- NPI assigned
- Jun 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 24728 | AZ | Primary |
Addresses
Primary practice location
811 Ainsworth Dr
Suite 101
Prescott, AZ 86301-1687
Mailing address
811 Ainsworth Dr
Ste 101
Prescott, AZ 86301-1687
Phone (928) 771-5282
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 482167 | Medicaid | AZ | |
| 340017265 | Other | AZ | RAILROAD MEDICARE |
| AZ0855380 | Other | AZ | BLUE CROSS/BLUE SHIELD |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prescott Urology LTD | Specialist | Current | Accepting new patients |
Locations
811 Ainsworth Dr
Ste 101
Prescott, AZ 86301
Phone (520) 771-5282
Organizations & group practices 1
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.
-
- Specialist
- Prescott, AZ
- NPI 1972549517
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564099200000",
"number": "1952339723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "811 AINSWORTH DR",
"address_2": "STE 101",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863011687",
"telephone_number": "928-771-5282",
"fax_number": "928-771-5283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "811 AINSWORTH DR",
"address_2": "SUITE 101",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863011687",
"telephone_number": "928-771-5282",
"fax_number": "928-771-5283"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANWICK",
"first_name": "JEFFREY",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-29",
"last_updated": "2019-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "AZ",
"license": "24728",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "482167",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "340017265",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "AZ0855380",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Prescott, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.