Organization Active NPI

Western Med Group LLC

  • Interventional Pain Medicine Physician
  • Gilbert, AZ
National Provider Identifier
1295404978
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
WESTERN MED GROUP LLC
Practice address
1515 N Gilbert Rd Ste D101
Gilbert, AZ 85234-2318
Phone
(480) 838-6696
NPI assigned
Sep 7, 2021
Last updated
Feb 24, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
WESTERN MED GROUP LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Authorized official

Name
Dr. Thomas Moshiri, MDNPI 1487628442
Title
Manager
Phone
(602) 441-3573

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X Primary
Durable Medical Equipment & Medical Supplies 332B00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

1515 N Gilbert Rd Ste D101
Gilbert, AZ 85234-2318

Mailing address

21001 N Tatum Blvd Ste 1630-606
Phoenix, AZ 85050-4242
Phone (602) 354-5310

Other practice location 1

3614 E Southern Ave Ste 105
Mesa, AZ 85206-2510
Phone (602) 354-5310

National Provider Directory

National Provider Directory
Part of
Western Med Group LLC

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1630972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645660800000",
    "number": "1295404978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21001 N TATUM BLVD STE 1630-606",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850504242",
            "telephone_number": "602-354-5310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 N GILBERT RD STE D101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342318",
            "telephone_number": "480-838-6696"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3614 E Southern Ave Ste 105",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852062510",
            "country_code": "US",
            "telephone_number": "602-354-5310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WESTERN MED GROUP LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WESTERN MED GROUP LLC",
        "enumeration_date": "2021-09-07",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A",
        "authorized_official_last_name": "MOSHIRI",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "602-441-3573",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; 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.