NPIMap

Individual provider Active NPI

Douglas M. Lakin, M.D.

  • Internal Medicine Physician
  • Scottsdale, AZ
National Provider Identifier
1992783492
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
19362 Issued in AZ
Practice address
9977 N 90TH St
#180
Scottsdale, AZ 85258-4423
Phone
(480) 614-5800
Fax
(480) 614-6322
NPI assigned
Jan 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 19362 AZ Primary

Addresses

Primary practice location

9977 N 90TH St
#180
Scottsdale, AZ 85258-4423

Mailing address

9977 N 90TH St
#180
Scottsdale, AZ 85258-4423
Phone (480) 614-5800

Other identifiers 2

IdentifierTypeStateIssuer
Z25901OtherAZPTAN
19362OtherAZSTATE MEDCIAL LICENSE

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
I20051005001291 AZ Practitioner - Internal Medicine 3173548492 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Johns Hopkins University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9977 N 90TH St
Suite 180
Scottsdale, AZ 85258-4426

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Paradise Valley Medical Clinic PC Internal Medicine CurrentSince Jul 2, 2013 Accepting new patients

Locations

9977 N 90th St
Ste 180
Scottsdale, AZ 85258
Phone (480) 614-5800

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71487
  • Direct secure messaging: douglas.lakin@doctordoug.directbygreenway.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1992783492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9977 N 90TH ST",
            "address_2": "#180",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584423",
            "telephone_number": "480-614-5800",
            "fax_number": "480-614-6322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9977 N 90TH ST",
            "address_2": "#180",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584423",
            "telephone_number": "480-614-5800",
            "fax_number": "480-614-6322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKIN",
        "first_name": "DOUGLAS",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "19362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "Z25901",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDCIAL LICENSE",
            "identifier": "19362",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.