Mesa Medical Group LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MESA MEDICAL GROUP LLC

Practice address

5233 E Southern Ave
Suite #104
Mesa, AZ 85206-3625

Phone

(480) 820-2882

Fax

(480) 830-2881

NPI assigned

May 30, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Mark A Zitnik, DC

Title

Owner

Phone

(480) 830-2882

Specialties & licenses 2

Addresses

Other names 1

• Backfit Health & Spine Doing business as

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2184/brand/1/csg/21/fhir/r4

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

{
    "created_epoch": "1338336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594080000000",
    "number": "1124389770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 W GUADALUPE RD",
            "address_2": "SUITE #120",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852333042",
            "telephone_number": "480-926-7800",
            "fax_number": "480-926-2260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5233 E SOUTHERN AVE",
            "address_2": "SUITE #104",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063625",
            "telephone_number": "480-820-2882",
            "fax_number": "480-830-2881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESA MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-30",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A",
        "authorized_official_last_name": "ZITNIK",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-830-2882",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "7150",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Backfit Health & Spine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Backfit Health & Spine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mesa Hospitalist PLLC
• Mesa I Enterprises, LLC
• Mesa Implants & Periodontics, LLC
• Mesa Kidtastic Dental LLC
• Mesa Medical Center Inc.
• Mesa Modern Dentistry, LLP
• Mesa Mountain PDC PLLC
• Mesa Naturopathic, PLLC
• Mesa Obstetricians & Gynecologists, LTD
• Mesa Outpatient Treatment Center LLC

• Family Medicine Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.