NPIMap

Organization Active NPI

Infinity Medical Providers LLC

Doing business as Infinity Medical Providers

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1154957678
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
INFINITY MEDICAL PROVIDERS LLC
Doing business as
Infinity Medical Providers
Practice address
350 E Eva St
Phoenix, AZ 85020-2564
Phone
(773) 410-1676
NPI assigned
Mar 16, 2020
Last updated
Sep 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Authorized official

Name
Kareem McCleskey
Title
Administrator
Phone
(602) 699-4066

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

350 E Eva St
Phoenix, AZ 85020-2564

Mailing address

21001 N Tatum Blvd
Ste 1630 Box 941
Phoenix, AZ 85050-4242
Phone (602) 699-4066

Other practice location 1

1914 J N Pease Pl
Charlotte, NC 28262-4504
Phone (602) 699-4066 ext. 101

Other identifiers 1

IdentifierTypeStateIssuer
004822MedicaidAZ

Other names 1

  • Infinity Medical Providers Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.infinitympaz.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200414003938 AZ Part B Supplier - Clinic/Group Practice 6002246006 Receives reassigned benefits from 8 practitioners
Practice locations: Phoenix, AZ
O20241106003740 NC Part B Supplier - Clinic/Group Practice 6002246006 Receives reassigned benefits from 2 practitioners
Practice locations: Charlotte, NC

National Provider Directory

National Provider Directory

Locations

21001 N Tatum Blvd
Ste 1630
Phoenix, AZ 85050
Phone (408) 718-0568

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21825/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 10

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": "1584316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727654400000",
    "number": "1154957678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21001 N TATUM BLVD",
            "address_2": "STE 1630 BOX 941",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850504242",
            "telephone_number": "602-699-4066",
            "fax_number": "480-275-4229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 E EVA ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202564",
            "telephone_number": "773-410-1676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1914 J N Pease Pl",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282624504",
            "country_code": "US",
            "telephone_number": "602-699-4066 x101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INFINITY MEDICAL PROVIDERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-16",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A",
        "authorized_official_last_name": "MCCLESKEY",
        "authorized_official_first_name": "KAREEM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "602-699-4066"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004822",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.infinitympaz.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Kareo EMR",
            "address_1": "21001 N Tatum Blvd Ste 1630",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850504242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Infinity Medical Providers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 30, 2024; 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.