Organization Active NPI

Xpress Neurodiagnostic LLC

  • Neurology Physician
  • Phoenix, AZ
National Provider Identifier
1578381158
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
XPRESS NEURODIAGNOSTIC LLC
Practice address
3719 E Louise Dr
Phoenix, AZ 85050-8314
Phone
(623) 328-7087
NPI assigned
Oct 1, 2024
Last updated
Nov 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Authorized official

Name
Aziz Mallik
Title
Member
Phone
(623) 238-3889

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X NU Primary
Epilepsy Physician 2084E0001X NU

Addresses

Primary practice location

3719 E Louise Dr
Phoenix, AZ 85050-8314

Mailing address

12409 W Indian School Rd Ste A108
Avondale, AZ 85392-9503
Phone (623) 238-3889

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250702000617 AZ Part B Supplier - Clinic/Group Practice 0446763486 Receives reassigned benefits from 1 practitioner
Practice locations: Phoenix, AZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1727740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762992000000",
    "number": "1578381158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12409 W INDIAN SCHOOL RD STE A108",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853929503",
            "telephone_number": "623-238-3889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3719 E LOUISE DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850508314",
            "telephone_number": "623-328-7087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "XPRESS NEURODIAGNOSTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-01",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A",
        "authorized_official_last_name": "MALLIK",
        "authorized_official_first_name": "AZIZ",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "623-238-3889"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2084E0001X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Epilepsy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2025; 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.