Active NPI
Smi Imaging, LLC
- Diagnostic Radiology Physician
- Gilbert, AZ
National Provider Identifier
1356574537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- OTC4698
- Legal business name
- SMI IMAGING, LLC
- Practice address
- 2680 S Val Vista Dr BLDG 7
Suite 135
Gilbert, AZ 85295-2152 - Phone
- (480) 584-4900
- Fax
- (480) 584-4910
- NPI assigned
- Sep 3, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Howard J Simon, M.D.
- Title
- President
- Phone
- (480) 264-2400
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | OTC4698 | AZ | Primary |
Addresses
Primary practice location
2680 S Val Vista Dr BLDG 7
Suite 135
Gilbert, AZ 85295-2152
Mailing address
PO Box 7368
Orange, CA 92863-7368
Phone (714) 571-5000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 473154 | Medicaid | AZ | |
| P00811052 | Other | RAILROAD MEDICARE |
Other names 1
- SimonMed Imaging - Spectrum
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 03D1098155 | Simonmed Imaging - Spectrum | Certificate of waiver | Jan 9, 2027 |
National Provider Directory
National Provider DirectoryMember of 2
Organizations this organization is a member of, according to the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251936000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1276041600000",
"number": "1356574537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7368",
"city": "ORANGE",
"state": "CA",
"postal_code": "928637368",
"telephone_number": "714-571-5000",
"fax_number": "714-571-5055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2680 S VAL VISTA DR BLDG 7",
"address_2": "SUITE 135",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852952152",
"telephone_number": "480-584-4900",
"fax_number": "480-584-4910"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SMI IMAGING, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2009-09-03",
"last_updated": "2010-06-09",
"status": "A",
"authorized_official_last_name": "SIMON",
"authorized_official_first_name": "HOWARD",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "480-264-2400",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": "AZ",
"license": "OTC4698",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "473154",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00811052",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "SimonMed Imaging - Spectrum",
"code": "5",
"type": "Other Name"
}
]
}
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 Jun 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.