Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1124180054 Individual Practitioner Male Practitioner

Dr. Samuel Ponce Nandin , MD

General Practice • Goodyear, AZ

Professional Overview & Biography Verified Profile Summary

Dr. Samuel Nandin, MD is a registered healthcare professional specializing in General Practice in Goodyear, AZ. Practice services are available at 13851 W LA MAR BLVD under active NPI credentials.

Frequently performed procedures and clinical services include established patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

13851 W La Mar Blvd
Ste C

Goodyear, AZ 853381389

Telephone 6239252622
Fax 6239259260
Associated Practice Facility / Clinic
🏢 Paul S. Charnetsky, M.d. P.c. Facility NPI 1982623542

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Goodyear, AZ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 12.3 Yrs
State Avg: 21.3 Yrs
Regional Practice Density
6 Specialists

Practicing in Goodyear, AZ (259 Statewide)

Telehealth Adoption Rate
16.7% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
1.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2019)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
66 24 $107.69 $106.36

Medical Specialties & State Licenses

General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License AZ AZ15582

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Owcp
106223600 (AZ)
Commercial Insurance / Payer ID Az. Foundation For Medica
562491245 (AZ)
Commercial Insurance / Payer ID Life Wise Healthplan
562491245 (AZ)
Commercial Insurance / Payer ID Unitedhealth Care
562491245 (AZ)
Commercial Insurance / Payer ID Scf Of Arizona
562491245 (AZ)
Commercial Insurance / Payer ID Bcbs Of Az
AZ0766630 (AZ)
Commercial Insurance / Payer ID Humana
562491245 (AZ)
Commercial Insurance / Payer ID Ahcccs
273607001 (AZ)
Commercial Insurance / Payer ID Beechstreet Network
562491245 (AZ)
Commercial Insurance / Payer ID Health Net
2Z1748 (AZ)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Dr. Paul Charnetsky , MD

Internal Medicine

NPI 1477515021

Doctor of Medicine (M.D.)

Sarah Watson , COTA

Occupational Therapy Assistant

NPI 1578970885

Certified Occupational Therapy Assistant

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location June 21, 2018

Registered at 13851 W LA MAR BLVD, STE C, GOODYEAR, AZ 853381389 (Tel: 6239252622)

📍
Updated Business Mailing Address June 21, 2018

Registered at 13851 W LA MAR BLVD, STE C, GOODYEAR, AZ 853381389 (Tel: 6239252622)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 21, 2018

General Practice (License #AZ15582 in AZ)

NPI Profile Active December 12, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location December 12, 2007

Registered at 378 N. LITCHFIELD RD. #116, GOODYEAR, AZ 853381239 (Tel: 6239252622)

📍
Updated Business Mailing Address December 12, 2007

Registered at 378 N. LITCHFIELD RD. #116, GOODYEAR, AZ 853381239 (Tel: 6239252622)

👤
Provider Name / Credentials Updated December 12, 2007

Recorded as SAMUEL NANDIN, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 12, 2007

Family Medicine (License #15582 in AZ)

🟢
Initial NPI Registration & Enumeration December 15, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1124180054
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 15, 2006
Last Update: June 21, 2018
Sole Proprietor: Yes

Mailing Address

13851 W La Mar Blvd, Ste C

Goodyear, AZ 853381389

Phone: 6239252622

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.