NPIMap

Organization Active NPI

Smi Imaging LLC

  • Mobile Mammography Clinic/Center
  • Tempe, AZ
National Provider Identifier
1609412642
Registry record updated Jul 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mobile Mammography Clinic/CenterTaxonomy code 261QR0207X
Legal business name
SMI IMAGING LLC
Practice address
8380 S Kyrene Rd Ste 105
Tempe, AZ 85284-2120
Phone
(480) 961-5760
NPI assigned
Nov 25, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2020

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

Authorized official

Name
Howard John Simon, MDNPI 1073583068
Title
Ceo
Phone
(480) 478-6545

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mobile Mammography Clinic/Center 261QR0207X Primary

Addresses

Primary practice location

8380 S Kyrene Rd Ste 105
Tempe, AZ 85284-2120

Mailing address

6900 E Camelback Rd Ste 700
Scottsdale, AZ 85251-2400
Phone (866) 614-8555

Other names 1

  • MOBILE ONSITE MAMMOGRAPHY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180829003142 AZ Part B Supplier - Clinic/Group Practice 3476696220 Receives reassigned benefits from 183 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 61

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

View all 61

NPI Registry JSON

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

{
    "created_epoch": "1574640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595808000000",
    "number": "1609412642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 E CAMELBACK RD STE 700",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852512400",
            "telephone_number": "866-614-8555",
            "fax_number": "602-302-5706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8380 S KYRENE RD STE 105",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852842120",
            "telephone_number": "480-961-5760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMI IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-25",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A",
        "authorized_official_last_name": "SIMON",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "480-478-6545",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0207X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile Mammography",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOBILE ONSITE MAMMOGRAPHY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MOBILE ONSITE MAMMOGRAPHY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; 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.