NPIMap

Organization Active NPI

Southwest Sports Medicine & Orthopaedic Surgery Clinic, LTD.

  • Orthopaedic Surgery Physician
  • Scottsdale, AZ
National Provider Identifier
1295827384
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
SOUTHWEST SPORTS MEDICINE & ORTHOPAEDIC SURGERY CLINIC, LTD.
Practice address
8580 E Shea Blvd
Scottsdale, AZ 85260-6685
Phone
(480) 763-5950
Fax
(480) 763-1375
NPI assigned
Sep 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

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

Authorized official

Name
Dr. Angelo J Mattalino, M.D.NPI 1770689671
Title
President
Phone
(480) 763-5950

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207X00000X Primary
Sports Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2251S0007X
Orthopedic Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2251X0800X

Addresses

Primary practice location

8580 E Shea Blvd
Scottsdale, AZ 85260-6685

Mailing address

8580 E Shea Blvd Ste 120
Scottsdale, AZ 85260-6684
Phone (480) 763-5950

National Provider Directory

National Provider Directory

Locations

8580 E Shea Blvd
Scottsdale, AZ 85260
Phone (480) 763-5950

8580 E Shea Blvd
Ste 120
Scottsdale, AZ 85260
Phone (480) 763-5950

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642464000000",
    "number": "1295827384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8580 E SHEA BLVD STE 120",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852606684",
            "telephone_number": "480-763-5950",
            "fax_number": "480-763-1375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8580 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852606685",
            "telephone_number": "480-763-5950",
            "fax_number": "480-763-1375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST SPORTS MEDICINE & ORTHOPAEDIC SURGERY CLINIC, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A",
        "authorized_official_last_name": "MATTALINO",
        "authorized_official_first_name": "ANGELO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-763-5950",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.