Organization Active NPI

Arizona Medicos Inc

  • Clinic/Center
  • Green Valley, AZ
National Provider Identifier
1518219740
Registry record updated Oct 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
ARIZONA MEDICOS INC
Practice address
120 W Calle de Las Tiendas
Green Valley, AZ 85614-4326
Phone
(866) 862-6414
Fax
(866) 851-4817
NPI assigned
Oct 11, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2012

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

Authorized official

Name
DD Sande
Title
Credentialing Specialist
Phone
(520) 409-3445

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

120 W Calle de Las Tiendas
Green Valley, AZ 85614-4326

Mailing address

120 W Calle de Las Tiendas
Green Valley, AZ 85614-4326
Phone (866) 862-6414

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130111000451 AZ Part B Supplier - Clinic/Group Practice 6709039290 Receives reassigned benefits from 3 practitioners
Practice locations: Green Valley, 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
03D2052381Arizona Medicos, Inc120 W Calle de Las Tiendas, Green Valley, AZ 85614Certificate of waiverJan 8, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1349913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349913600000",
    "number": "1518219740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W CALLE DE LAS TIENDAS",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856144326",
            "telephone_number": "866-862-6414",
            "fax_number": "866-851-4817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W CALLE DE LAS TIENDAS",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856144326",
            "telephone_number": "866-862-6414",
            "fax_number": "866-851-4817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA MEDICOS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-11",
        "last_updated": "2012-10-11",
        "status": "A",
        "authorized_official_last_name": "SANDE",
        "authorized_official_first_name": "DD",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "520-409-3445"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; 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.