Organization Active NPI

Iridium Pain Management PLLC

  • Interventional Pain Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1114499472
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
IRIDIUM PAIN MANAGEMENT PLLC
Practice address
4045 E Bell Rd Ste 147
Phoenix, AZ 85032-2239
Phone
(602) 795-0207
NPI assigned
Dec 27, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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

Authorized official

Name
Thomas Moshiri, MD
Title
Manager
Phone
(424) 322-0980

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X Primary

Addresses

Primary practice location

4045 E Bell Rd Ste 147
Phoenix, AZ 85032-2239

Mailing address

10810 N Tatum Blvd Ste 102-302
Phoenix, AZ 85028

Other practice location 1

4045 E Bell Rd Ste 149
Phoenix, AZ 85032-2239
Phone (424) 322-0980

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1545868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587600000000",
    "number": "1114499472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10810 N TATUM BLVD STE 102-302",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 E BELL RD STE 147",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322239",
            "telephone_number": "602-795-0207"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4045 E Bell Rd Ste 149",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850322239",
            "country_code": "US",
            "telephone_number": "424-322-0980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "IRIDIUM PAIN MANAGEMENT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-27",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A",
        "authorized_official_last_name": "MOSHIRI",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "424-322-0980",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2020; 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.