Arizona Minimally Invasive Sinus Institute PLLC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

ARIZONA MINIMALLY INVASIVE SINUS INSTITUTE PLLC

Practice address

19636 N 27TH Ave Ste 206
Phoenix, AZ 85027-4015

Phone

(602) 788-0088

Fax

(602) 931-4544

NPI assigned

Jul 29, 2013

Organization subpart

No

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

Authorized official

Name

Susan L Traikovich

Title

Manager

Phone

(623) 516-0930

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Surgcenter of Deer Valley, LLC

  • Ambulatory Surgical Clinic/Center
  • Phoenix, AZ
  • NPI 1720325160

  Member Of

  NPD member

Practitioners 2

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

• Robert S Bridge, M.D.

  • Specialist
  • Phoenix, AZ
  • NPI 1700882990
  Medicare reassignment
• Megan Lyons

  • Physician Assistant
  • Phoenix, AZ
  • NPI 1306556162
  Medicare reassignment

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

{
    "created_epoch": "1375056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546732800000",
    "number": "1376985549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19636 N 27TH AVE STE 206",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274015",
            "telephone_number": "602-788-0088",
            "fax_number": "602-931-4544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19636 N 27TH AVE STE 206",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274015",
            "telephone_number": "602-788-0088",
            "fax_number": "602-931-4544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA MINIMALLY INVASIVE SINUS INSTITUTE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-29",
        "last_updated": "2019-01-06",
        "status": "A",
        "authorized_official_last_name": "TRAIKOVICH",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "623-516-0930"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arizona Medical Review Officers, Inc.
• Arizona Medical Specialists PC
• Arizona Medical Spine Institute (Arizona Back Institute)
• Arizona Medical Spine Institute, PC (Arizona Back Institue)
• Arizona Mental Health Institute LLC
• Arizona Mobile Anesthesia LLC
• Arizona Mobile Dental, PC
• Arizona Mobile Doctors, LLC
• Arizona Mobile Wound Care Services, PLLC
• Arizona Mua Specialists, LLC

• Otolaryngology Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Otolaryngology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2019; 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.