Miracle on 29TH Street

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

AL10509H Issued in AZ

Legal business name

MIRACLE ON 29TH STREET

Doing business as

Koala-D Meds

Practice address

18210 N 29TH St
Phoenix, AZ 85032-1103

Phone

(480) 302-1101

NPI assigned

Mar 19, 2018

Last updated

Sep 12, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Troy BerkleyNPI 1104483460

Title

Owner

Phone

(480) 302-1101

Specialties & licenses 1

Addresses

Other names 1

• Koala-D Meds Doing business as

Practitioners 1

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.

• Troy Berkley, HOME HEALTH AID

  • Case Manager/Care Coordinator
  • Phoenix, AZ
  • NPI 1104483460
  NPD (past) Authorized official

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

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757635200000",
    "number": "1255835997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18210 N 29TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850321103",
            "telephone_number": "480-302-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18210 N 29TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850321103",
            "telephone_number": "480-302-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACLE ON 29TH STREET",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-19",
        "last_updated": "2025-09-12",
        "status": "A",
        "authorized_official_last_name": "BERKLEY",
        "authorized_official_first_name": "TROY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-302-1101",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": "AZ",
            "license": "AL10509H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Koala-D Meds",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brandon M Minzer, MD
• Faryal Faisal Mir, DO
• Jennifer Thomas Mirabelli, DMD, MSD
• Robert Mark Mirabelli, DMD
• Miracle Consulting (Behavioral Group Innovations(BGI))
• Miracle Wellness Center LLC
• Mirage Hospice Care Inc
• Mirage Medical LLC
• Mirage Podiatry Foot and Ankle Specialists
• Gregory Miraglia, PHARM. D.

• Case Manager/Care Coordinator in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Case Manager/Care Coordinator in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; 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.