OrganizationActive
Phoenix Id LLC
NPI 1205027646 · Infectious Disease Physician · Phoenix, AZ
Phoenix Id LLC is a Infectious Disease Physician organization in Phoenix, AZ (NPI 1205027646).
Provider details
- NPI number
- 1205027646
- Entity type
- Organization
- Primary specialty
- Infectious Disease PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jacob Oommen, Owner(480) 907-7786
- License
- 37316 (AZ)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
340 E Palm Ln Ste 100
Phoenix, AZ 85004-4528
Phone: (602) 254-1136
Fax: (602) 272-1720
Street-level locationGet directions
Mailing address
3303 S Lindsay Rd Ste 123
Gilbert, AZ 85297-2100
Registry dates
- Enumerated
- 2007-08-08
- Last updated
- 2008-10-09
Frequently asked questions
- What is Phoenix Id LLC's NPI number?
- Phoenix Id LLC's National Provider Identifier (NPI) is 1205027646, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Phoenix Id LLC?
- Phoenix Id LLC is classified in the NPPES registry as Infectious Disease Physician (Allopathic & Osteopathic Physicians).
- Where is Phoenix Id LLC located?
- Phoenix Id LLC's practice location on file with NPPES is 340 E Palm Ln Ste 100, Phoenix, AZ 85004-4528.
- What is Phoenix Id LLC's phone number?
- The practice phone number listed in the NPPES registry for Phoenix Id LLC is (602) 254-1136.
- Who is the authorized official for Phoenix Id LLC?
- The authorized official listed on Phoenix Id LLC's NPPES record is Jacob Oommen, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Phoenix Id LLC's NPI active?
- Yes — Phoenix Id LLC's NPI (1205027646) is active in the NPPES registry as of the last update on 2008-10-09.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.