NPIMap

Organization Active NPI

Scottsdale Healthcare Corporation

Doing business as 92nd Street

  • Family Medicine Physician
  • Scottsdale, AZ
National Provider Identifier
1447635164
Registry record updated Feb 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SCOTTSDALE HEALTHCARE CORPORATION
Doing business as
92nd Street
Practice address
10277 N 92ND St
Suite 101
Scottsdale, AZ 85258-4564
Phone
(480) 609-1444
Fax
(480) 609-1359
NPI assigned
Jul 23, 2015
Last updated
Feb 2, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2019

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

Authorized official

Name
Mr. Richard Silver
Title
Ceo
Phone
(623) 434-6200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

10277 N 92ND St
Suite 101
Scottsdale, AZ 85258-4564

Mailing address

PO Box 845635
Los Angeles, CA 90084-5635
Phone (623) 434-6200

Other names 1

  • 92nd Street Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071005000449 AZ Part B Supplier - Clinic/Group Practice 5991603110 Receives reassigned benefits from 953 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Scottsdale Healthcare Corp114 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

7242 E Osborn Rd
Ste 400
Scottsdale, AZ 85251
Phone (480) 587-6145

Practitioners & affiliated clinicians

Practitioners 19

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 19

NPI Registry JSON

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

{
    "created_epoch": "1437609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549065600000",
    "number": "1447635164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845635",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900845635",
            "telephone_number": "623-434-6200",
            "fax_number": "623-434-6164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10277 N 92ND ST",
            "address_2": "SUITE 101",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584564",
            "telephone_number": "480-609-1444",
            "fax_number": "480-609-1359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTTSDALE HEALTHCARE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-23",
        "last_updated": "2019-02-02",
        "status": "A",
        "authorized_official_last_name": "SILVER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "623-434-6200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "92nd Street",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "92nd Street",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.