Organization Active NPI

Tri City Endocrinology PLLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Mesa, AZ
National Provider Identifier
1316612146
Registry record updated Aug 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
TRI CITY ENDOCRINOLOGY PLLC
Practice address
1520 S Dobson Rd Ste 218
Mesa, AZ 85202-4754
Phone
(480) 626-8737
NPI assigned
Aug 13, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2021

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

Authorized official

Name
Manal Alhakim, MDNPI 1699055566
Title
Member Manager
Phone
(480) 626-8737

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
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X Primary

Addresses

Primary practice location

1520 S Dobson Rd Ste 218
Mesa, AZ 85202-4754

Mailing address

1520 S Dobson Rd Ste 218
Mesa, AZ 85202-4754

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211011002140 AZ Part B Supplier - Clinic/Group Practice 7214335918 Receives reassigned benefits from 1 practitioner
Practice locations: Mesa, AZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1628812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628812800000",
    "number": "1316612146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 S DOBSON RD STE 218",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 S DOBSON RD STE 218",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024754",
            "telephone_number": "480-626-8737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI CITY ENDOCRINOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-13",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A",
        "authorized_official_last_name": "ALHAKIM",
        "authorized_official_first_name": "MANAL",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "480-626-8737",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2021; 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.