NPIMap

Organization Active NPI

Modern Sports Medicine LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Tucson, AZ
National Provider Identifier
1609662709
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
Legal business name
MODERN SPORTS MEDICINE LLC
Practice address
2900 E Broadway Blvd Ste 132
Tucson, AZ 85716-5348
Phone
(480) 306-6627
Fax
(480) 306-6696
NPI assigned
Apr 16, 2025
Last updated
Apr 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Authorized official

Name
Joshua Adams
Title
Owner
Phone
(480) 306-6627

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X Primary

Addresses

Primary practice location

2900 E Broadway Blvd Ste 132
Tucson, AZ 85716-5348

Mailing address

5590 W Chandler Blvd Ste 4
Chandler, AZ 85226-3744
Phone (480) 306-6627

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191120000879 AZ Part B Supplier - Clinic/Group Practice 6800228479 Receives reassigned benefits from 57 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tucson, AZ; Surprise, AZ; Sun Lakes, AZ; Phoenix, AZ; Peoria, AZ; Mesa, AZ; Chandler, AZ; Gilbert, AZ…

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Modern Sports Medicine LLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

406 N Litchfield Rd
Ste 204
Goodyear, AZ 85338
Phone (602) 995-0400

6910 E Chauncey Ln
Ste 115
Phoenix, AZ 85054
Phone (480) 473-5070

14819 N Del Webb Blvd
Sun City, AZ 85351

12515 W Bell Rd
Ste 103
Surprise, AZ 85378
Phone (623) 234-4171

Practitioners & affiliated clinicians

Practitioners 57

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.

View all 57

NPI Registry JSON

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

{
    "created_epoch": "1744761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744761600000",
    "number": "1609662709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5590 W CHANDLER BLVD STE 4",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852263744",
            "telephone_number": "480-306-6627",
            "fax_number": "480-306-6696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 E BROADWAY BLVD STE 132",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857165348",
            "telephone_number": "480-306-6627",
            "fax_number": "480-306-6696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN SPORTS MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-16",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-306-6627"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.