Organization Active NPI

Consultants in Internal Medicine, P.C.

  • Primary Care Clinic/Center
  • Glendale, AZ
National Provider Identifier
1568673499
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
19199 Issued in AZ
Legal business name
CONSULTANTS IN INTERNAL MEDICINE, P.C.
Practice address
5651 W Talavi Blvd Ste 170
Glendale, AZ 85306-1893
Phone
(602) 843-1313
Fax
(602) 843-0191
NPI assigned
May 24, 2007
Last updated
Aug 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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

Authorized official

Name
Tina M Light
Title
Admin
Phone
(602) 843-1313

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 19199 AZ Primary

Addresses

Primary practice location

5651 W Talavi Blvd Ste 170
Glendale, AZ 85306-1893

Mailing address

5701 W Talavi Blvd Ste 110
Glendale, AZ 85306-1887
Phone (602) 843-1313

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040521000005 AZ Part B Supplier - Clinic/Group Practice 1557352333 Receives reassigned benefits from 6 practitioners
Practice locations: Glendale, AZ

National Provider Directory

National Provider Directory

Locations

5651 W Talavi Blvd
Ste 170
Glendale, AZ 85306
Phone (602) 843-1313

5701 W Talavi Blvd
Ste 110
Glendale, AZ 85306
Phone (602) 843-1313

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690934400000",
    "number": "1568673499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 W TALAVI BLVD STE 110",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853061887",
            "telephone_number": "602-843-1313",
            "fax_number": "602-843-0191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5651 W TALAVI BLVD STE 170",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853061893",
            "telephone_number": "602-843-1313",
            "fax_number": "602-843-0191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONSULTANTS IN INTERNAL MEDICINE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A",
        "authorized_official_last_name": "LIGHT",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "602-843-1313"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AZ",
            "license": "19199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; 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.