Organization Active NPI

Az Integrated Neuro Spine & Pain LLC

  • Neurology Physician
  • Sun City, AZ
National Provider Identifier
1487155354
Registry record updated Oct 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
AZ INTEGRATED NEURO SPINE & PAIN LLC
Practice address
13640 N 99TH Ave Ste 100
Sun City, AZ 85351-0001
Phone
(623) 322-5700
Fax
(866) 540-1170
NPI assigned
Feb 26, 2018
Last updated
Oct 24, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2019

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

Authorized official

Name
Maninder S Kahlon, MDNPI 1184695165
Title
Member
Phone
(623) 322-5700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X Primary
Pain Medicine Physician 208VP0000X

Addresses

Primary practice location

13640 N 99TH Ave Ste 100
Sun City, AZ 85351-0001

Mailing address

13640 N 99TH Ave Ste 100
Sun City, AZ 85351-0001
Phone (623) 322-5700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180402001530 AZ Part B Supplier - Clinic/Group Practice 5597027516 Receives reassigned benefits from 41 practitioners
Practice locations: Phoenix, AZ; Sun City West, AZ; Sun City, AZ; Glendale, AZ

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
03D2111784Az Integrated Neuro Spine & Pain13640 N 99TH Ave Ste 100, Sun City, AZ 85351Certificate of waiverApr 13, 2028

National Provider Directory

National Provider Directory

Locations

6320 W Union Hills Dr
Ste 230
Glendale, AZ 85308
Phone (602) 933-3937

7200 W Bell Rd
Bldg 8
Glendale, AZ 85308

14418 W Meeker Blvd
Ste 100
Sun City West, AZ 85375
Phone (602) 463-4872

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGIDBD

Practitioners & affiliated clinicians

Practitioners 41

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 41

NPI Registry JSON

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

{
    "created_epoch": "1519603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571875200000",
    "number": "1487155354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13640 N 99TH AVE STE 100",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853510001",
            "telephone_number": "623-322-5700",
            "fax_number": "866-540-1170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13640 N 99TH AVE STE 100",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853510001",
            "telephone_number": "623-322-5700",
            "fax_number": "866-540-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZ INTEGRATED NEURO SPINE & PAIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-26",
        "last_updated": "2019-10-24",
        "status": "A",
        "authorized_official_last_name": "KAHLON",
        "authorized_official_first_name": "MANINDER",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "623-322-5700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; 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.