Organization Active NPI

Mirage Podiatry Foot and Ankle Specialists

  • Foot & Ankle Surgery Podiatrist
  • Phoenix, AZ
National Provider Identifier
1114545506
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
MIRAGE PODIATRY FOOT AND ANKLE SPECIALISTS
Practice address
9250 N 3Rd St Ste 3020
Phoenix, AZ 85020-2425
Phone
(480) 939-3440
Fax
(480) 939-3448
NPI assigned
Jul 11, 2020
Last updated
Sep 26, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Authorized official

Name
Dr. Hammad Mohammad Zafar, DPMNPI 1164809711
Title
Doctor
Phone
(480) 358-7970

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatric Clinic/Center 261QP1100X NU
Durable Medical Equipment & Medical Supplies 332B00000X NU
Foot & Ankle Surgery Podiatrist 213ES0103X NU Primary

Addresses

Primary practice location

9250 N 3Rd St Ste 3020
Phoenix, AZ 85020-2425

Mailing address

9250 N 3Rd St Ste 3020
Phoenix, AZ 85020-2425
Phone (480) 939-3440

Other identifiers 2

IdentifierTypeStateIssuer
1164752283MedicaidAZ
1164809711MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200819003053 AZ Part B Supplier - Clinic/Group Practice 6002232162 Receives reassigned benefits from 3 practitioners
Practice locations: Phoenix, AZ
O20201029001966 AZ DME Supplier - Physician - Podiatry 6002232162 Practice locations: Phoenix, AZ

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1594425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695686400000",
    "number": "1114545506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9250 N 3RD ST STE 3020",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202425",
            "telephone_number": "480-939-3440",
            "fax_number": "480-939-3448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9250 N 3RD ST STE 3020",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202425",
            "telephone_number": "480-939-3440",
            "fax_number": "480-939-3448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRAGE PODIATRY FOOT AND ANKLE SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-11",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A",
        "authorized_official_last_name": "ZAFAR",
        "authorized_official_first_name": "HAMMAD",
        "authorized_official_middle_name": "MOHAMMAD",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "480-358-7970",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164752283",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164809711",
            "state": "AZ"
        }
    ],
    "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 Sep 26, 2023; 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.