NPIMap

Organization Active NPI

Desert Institute for Spine Care PC

  • Specialist
  • Phoenix, AZ
National Provider Identifier
1205856127
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
30422 Issued in AZ
Legal business name
DESERT INSTITUTE FOR SPINE CARE PC
Practice address
1635 E Myrtle Ave Suite 400
Phoenix, AZ 85020-5514
Phone
(602) 944-2900
Fax
(602) 944-0064
NPI assigned
Jul 21, 2006
Last updated
Jul 7, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Authorized official

Name
Christopher A YeungNPI 1205864006
Title
Owner
Phone
(602) 944-2900

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
Specialist 174400000X 30422 AZ Primary

Addresses

Primary practice location

1635 E Myrtle Ave Suite 400
Phoenix, AZ 85020-5514

Mailing address

1635 E Myrtle Ave Ste 400
Phoenix, AZ 85020-5514
Phone (602) 944-2900

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050706000341 AZ Part B Supplier - Clinic/Group Practice 1951347475 Receives reassigned benefits from 14 practitioners
Practice locations: Gilbert, AZ; Phoenix, AZ; Scottsdale, AZ
O20100930043078 AZ DME Supplier - Physician - General Practice 1951347475 Practice locations: Phoenix, AZ

National Provider Directory

National Provider Directory

Locations

18700 N 64th Dr
Ste 105A
Glendale, AZ 85308
Phone (623) 688-5075

1635 E Myrtle Ave
Phoenix, AZ 85020
Phone (602) 944-2900

8630 E Via de Ventura
Scottsdale, AZ 85258

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657152000000",
    "number": "1205856127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 E MYRTLE AVE STE 400",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850205514",
            "telephone_number": "602-944-2900",
            "fax_number": "602-944-0064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 E MYRTLE AVE SUITE 400",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850205514",
            "telephone_number": "602-944-2900",
            "fax_number": "602-944-0064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT INSTITUTE FOR SPINE CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A",
        "authorized_official_last_name": "YEUNG",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-944-2900"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AZ",
            "license": "30422",
            "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 Jul 7, 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.