Phoenix Medical Associates, P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

36100398 Issued in IL

Legal business name

PHOENIX MEDICAL ASSOCIATES, P.C.

Practice address

3718 N Ashland Ave
Chicago, IL 60613-4793

Phone

(773) 327-9900

Fax

(773) 327-0589

NPI assigned

Jul 11, 2006

Last updated

Feb 23, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Florian Miranzadeh, DO

Title

President / Owner

Phone

(773) 327-9900

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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.

• B Florian Miranzadeh, DO

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1609862135
  Medicare reassignment NPD
• Jennifer Racine

  • Family Nurse Practitioner
  • Chicago, IL
  • NPI 1922421643
  NPD (past)

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266883200000",
    "number": "1558396580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 OAKMONT LN",
            "address_2": "SUITE 1600",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595511",
            "telephone_number": "630-789-2550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3718 N ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606134793",
            "telephone_number": "773-327-9900",
            "fax_number": "773-327-0589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX MEDICAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2010-02-23",
        "status": "A",
        "authorized_official_last_name": "MIRANZADEH",
        "authorized_official_first_name": "FLORIAN",
        "authorized_official_title_or_position": "PRESIDENT / OWNER",
        "authorized_official_telephone_number": "773-327-9900",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "36100398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080171110",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVOCATE IL MASONIC ID",
            "identifier": "4010133",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "01629934",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mai Pho
• Phocused Consulting LLC (Phocused On Smiles)
• Phoenix BX LLC
• Phoenix Healthcare Services LLC
• Phoenix Medical Associates
• Phoenix Performance Therapy
• Phoenix Psychotherapy PLLC
• Phoenix Rising Counseling and Guidance, LLC
• Phoenix Underground Physical Therapy LLC
• Pamela Charity Phoenix

• Family Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2010; 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.