NPIMap

Organization Active NPI

Foothills Anesthesiology PC

  • Anesthesiology Physician
  • Tempe, AZ
National Provider Identifier
1063508315
Registry record updated Dec 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
FOOTHILLS ANESTHESIOLOGY PC
Practice address
2421 E Southern Ave Ste 7
Tempe, AZ 85282-7612
Phone
(480) 425-2160
Fax
(520) 546-4095
NPI assigned
Oct 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2022

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

Authorized official

Name
Kamal F Moukabary, MDNPI 1407861255
Title
Physician
Phone
(480) 425-2160

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
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

2421 E Southern Ave Ste 7
Tempe, AZ 85282-7612

Mailing address

PO Box 41150
Mesa, AZ 85274-1150
Phone (480) 425-2160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040413001710 AZ Part B Supplier - Clinic/Group Practice 5294729059 Receives reassigned benefits from 6 practitioners
Practice locations: Tucson, AZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

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": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670457600000",
    "number": "1063508315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41150",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852741150",
            "telephone_number": "480-425-2160",
            "fax_number": "480-351-8797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2421 E SOUTHERN AVE STE 7",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827612",
            "telephone_number": "480-425-2160",
            "fax_number": "520-546-4095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTHILLS ANESTHESIOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A",
        "authorized_official_last_name": "MOUKABARY",
        "authorized_official_first_name": "KAMAL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "480-425-2160",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.