NPIMap

Organization Active NPI

Advanced Minimally Invasive Surgical

  • Vascular Surgery Physician
  • Mesa, AZ
National Provider Identifier
1003664152
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
ADVANCED MINIMALLY INVASIVE SURGICAL
Practice address
1134 E University Dr Ste 111
Mesa, AZ 85203-8048
Phone
(480) 788-5621
Fax
(480) 779-1277
NPI assigned
May 13, 2024
Organization subpart
Yes
Parent organization
ADVANCED MINIMALLY INVASIVE SURGICALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Authorized official

Name
Kiup Alexander KimNPI 1225242985
Title
Owner
Phone
(480) 323-6072

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

1134 E University Dr Ste 111
Mesa, AZ 85203-8048

Mailing address

202 E Earll Dr Ste 360
Phoenix, AZ 85012-2677
Phone (480) 788-5621

National Provider Directory

National Provider Directory
Tax ID family
Advanced Minimally Invasive Surgical6 organizations share this tax ID, including this one
Part of
Advanced Minimally Invasive Surgical

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1134 E University Dr
Ste 111
Mesa, AZ 85203
Phone (480) 398-1220

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1715558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715558400000",
    "number": "1003664152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 E EARLL DR STE 360",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122677",
            "telephone_number": "480-788-5621",
            "fax_number": "480-779-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1134 E UNIVERSITY DR STE 111",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852038048",
            "telephone_number": "480-788-5621",
            "fax_number": "480-779-1277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED MINIMALLY INVASIVE SURGICAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVANCED MINIMALLY INVASIVE SURGICAL",
        "enumeration_date": "2024-05-13",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "KIUP",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-323-6072"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.