Organization Active NPI

Arizona Diagnostic Radiology Group, LLC

  • Diagnostic Radiology Physician
  • Gilbert, AZ
National Provider Identifier
1336757699
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
ARIZONA DIAGNOSTIC RADIOLOGY GROUP, LLC
Practice address
4915 E Baseline Rd
Gilbert, AZ 85234-2965
Phone
(480) 354-9200
Fax
(480) 354-9201
NPI assigned
Jul 22, 2020
Last updated
Mar 1, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Authorized official

Name
Norman Hames
Title
Authorized Official
Phone
(310) 445-2800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

4915 E Baseline Rd
Gilbert, AZ 85234-2965

Mailing address

1160 Pittsford Victor Rd Ste D
Pittsford, NY 14534-3825
Phone (585) 218-8019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, CA, NY, TN, HI, CO, OH, TX, SC, FL, DC, ID, IL, IA, CT, WA, IN, WI19 enrollments

Enrollment records 19

Enrollment IDStateProvider typePAC IDDetails
O20200805001519 AZ Part B Supplier - Clinic/Group Practice 1658796859 Receives reassigned benefits from 41 practitioners
Practice locations: Mesa, AZ; Tempe, AZ; Scottsdale, AZ; Phoenix, AZ; Peoria, AZ; Glendale, AZ; Gilbert, AZ; Chandler, AZ…
O20200901002520 CA Part B Supplier - Clinic/Group Practice 1658796859 Receives reassigned benefits from 49 practitioners
O20211028002494 NY Part B Supplier - Clinic/Group Practice 1658796859 Receives reassigned benefits from 5 practitioners
Practice locations: Hewlett, NY; New York, NY; Rye, NY; Woodbury, NY
O20211110000910 TN Part B Supplier - Clinic/Group Practice 1658796859 Receives reassigned benefits from 2 practitioners
Practice locations: College Grove, TN; Knoxville, TN
O20211201000212 HI Part B Supplier - Clinic/Group Practice 1658796859 Receives reassigned benefits from 2 practitioners
Practice locations: Kamuela, HI
O20220923001480 CO Part B Supplier - Clinic/Group Practice 1658796859 Receives reassigned benefits from 2 practitioners
Practice locations: Denver, CO; Littleton, CO
O20221213000314 OH Part B Supplier - Clinic/Group Practice 1658796859 Receives reassigned benefits from 1 practitioner
Practice locations: Loveland, OH
O20221213001235 TX Part B Supplier - Clinic/Group Practice 1658796859 Receives reassigned benefits from 3 practitioners
Practice locations: Whitehouse, TX; Dallas, TX; Spring, TX
O20230126000207 SC Part B Supplier - Clinic/Group Practice 1658796859 Receives reassigned benefits from 2 practitioners
Practice locations: Murrells Inlet, SC; Bluffton, SC
O20230201000530 FL Part B Supplier - Clinic/Group Practice 1658796859 Receives reassigned benefits from 6 practitioners
Practice locations: Aventura, FL; Jacksonville, FL; Naples, FL; Ponte Vedra Beach, FL
O20230502000089 DC Part B Supplier - Clinic/Group Practice 1658796859 Receives reassigned benefits from 1 practitioner
Practice locations: Bethesda, MD; MC Lean, VA
O20230709000131 ID Part B Supplier - Clinic/Group Practice 1658796859 Receives reassigned benefits from 4 practitioners
Practice locations: Idaho Falls, ID; Boise, ID; Eagle, ID
O20240926003413 IL Part B Supplier - Clinic/Group Practice 1658796859 Receives reassigned benefits from 2 practitioners
Practice locations: Chicago, IL; Vernon Hills, IL
O20241113004341 IA Part B Supplier - Clinic/Group Practice 1658796859 Receives reassigned benefits from 1 practitioner
Practice locations: Clive, IA
O20241230000893 CT Part B Supplier - Clinic/Group Practice 1658796859 Receives reassigned benefits from 2 practitioners
Practice locations: New Britain, CT; Ridgefield, CT
O20250501001315 WA Part B Supplier - Clinic/Group Practice 1658796859 Receives reassigned benefits from 1 practitioner
Practice locations: Mercer Island, WA
O20250701004648 IN Part B Supplier - Clinic/Group Practice 1658796859 Receives reassigned benefits from 2 practitioners
Practice locations: Carmel, IN
O20250718000070 FL Part B Supplier - Clinic/Group Practice 1658796859 Receives reassigned benefits from 1 practitioner
Practice locations: Orange Park, FL
O20251203003637 WI Part B Supplier - Clinic/Group Practice 1658796859 Receives reassigned benefits from 1 practitioner
Practice locations: Neenah, WI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2059221Arizona Diagnostic Radiology Group LLC4915 E Baseline Rd, Ste 116, Gilbert, AZ 85234Certificate of waiverMay 19, 2027

National Provider Directory

National Provider Directory

Locations

1727 W Frye Rd
Ste 100
Chandler, AZ 85224

2201 W Fairview St
Ste 1
Chandler, AZ 85224
Phone (480) 389-2798

3591 S Mercy Rd
Ste 105
Gilbert, AZ 85297
Phone (480) 256-9061

7330 N 99th Ave
Ste 125
Glendale, AZ 85307
Phone (480) 455-1850

21300 N John Wayne Pkwy
Ste 113
Maricopa, AZ 85139
Phone (520) 568-6411

1840 S Stapley Dr
Ste 101
Mesa, AZ 85204
Phone (480) 464-8500

2032 N 75TH Ave
Phoenix, AZ 85035

3115 N 3rd Ave
Ste S140
Phoenix, AZ 85013

4530 E Ray Rd
Ste 160
Phoenix, AZ 85044
Phone (480) 893-1004

7469 E Monte Cristo Ave
Ste 200
Scottsdale, AZ 85260
Phone (480) 788-8910

465 N Roxbury Dr
Ste 100
Beverly Hills, CA 90210

27762 Antonio Pkwy
#L1418
Ladera Ranch, CA 92694
Phone (949) 922-9410

6440 South St
Lakewood, CA 90713
Phone (562) 299-6230

4500 Olivewood Ave
Riverside, CA 92501

800 E Highland Ave
San Bernardino, CA 92404
Phone (909) 450-0640

2320 N California St
Stockton, CA 95204
Phone (209) 466-2000

415 Rolling Oaks Dr
Ste 160
Thousand Oaks, CA 91361
Phone (805) 778-1513

8540 S Sepulveda Blvd
Ste 111
Westchester, CA 90045
Phone (310) 445-2951

5776 Lindero Canyon Rd
Apt 469
Westlake Village, CA 91362

1150G Pittsford Victor Rd
Pittsford, NY 14534

Practitioners & affiliated clinicians

Practitioners 163

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 163

NPI Registry JSON

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

{
    "created_epoch": "1595376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614556800000",
    "number": "1336757699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 PITTSFORD VICTOR RD STE D",
            "city": "PITTSFORD",
            "state": "NY",
            "postal_code": "145343825",
            "telephone_number": "585-218-8019",
            "fax_number": "585-218-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4915 E BASELINE RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342965",
            "telephone_number": "480-354-9200",
            "fax_number": "480-354-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA DIAGNOSTIC RADIOLOGY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-22",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A",
        "authorized_official_last_name": "HAMES",
        "authorized_official_first_name": "NORMAN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "310-445-2800"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "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 Mar 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.