Active NPI
SW Sports Medicine & Orthopedic Surgery
- Orthopaedic Surgery Physician
- Mesa, AZ
National Provider Identifier
1356584890
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 3696
- Legal business name
- SW SPORTS MEDICINE & ORTHOPEDIC SURGERY
- Practice address
- 2835 E. Brown Rd.
Ste. 101
Mesa, AZ 85213 - Phone
- (480) 860-2618
- Fax
- (480) 998-3879
- NPI assigned
- Apr 14, 2009
- Organization subpart
- Yes
- Parent organization
- SOUTHWEST SPORTS MEDICINE & ORTHOPEDIC SURGERY
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Angelo J. Mattalino, MD
- Title
- Owner
- Phone
- (480) 860-2618
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 3696 | AZ | Primary |
Addresses
Primary practice location
2835 E. Brown Rd.
Ste. 101
Mesa, AZ 85213
Mailing address
8129 N. 87TH Place
Scottsdale, AZ 85258
Phone (480) 860-2618
National Provider Directory
National Provider Directory- Part of
- Southwest Sports Medici
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239667200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1239667200000",
"number": "1356584890",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8129 N. 87TH PLACE",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "85258",
"telephone_number": "480-860-2618",
"fax_number": "480-998-3879"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2835 E. BROWN RD.",
"address_2": "STE. 101",
"city": "MESA",
"state": "AZ",
"postal_code": "85213",
"telephone_number": "480-860-2618",
"fax_number": "480-998-3879"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SW SPORTS MEDICINE & ORTHOPEDIC SURGERY",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SOUTHWEST SPORTS MEDICINE & ORTHOPEDIC SURGERY",
"enumeration_date": "2009-04-14",
"last_updated": "2009-04-14",
"status": "A",
"authorized_official_last_name": "MATTALINO",
"authorized_official_first_name": "ANGELO",
"authorized_official_middle_name": "J.",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "480-860-2618",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Orthopaedic Surgery",
"state": "AZ",
"license": "3696",
"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 Apr 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.