Individual provider Active NPI

Tin Trung Mai, M.D.

  • Diagnostic Radiology Physician
  • Miami, FL
National Provider Identifier
1639583974
Registry record updated May 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME 127577 Issued in FL
Practice address
1611 NW 12TH Ave
Department of Radiology
Miami, FL 33136-1005
Phone
(305) 243-5512
Fax
(305) 243-4613
NPI assigned
Jun 15, 2014
Last updated
May 20, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME 127577 FL Primary

Addresses

Primary practice location

1611 NW 12TH Ave
Department of Radiology
Miami, FL 33136-1005

Mailing address

1611 NW 12TH Ave
Department of Radiology
Miami, FL 33136-1005
Phone (305) 243-5512

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200730000986 AZ Practitioner - Diagnostic Radiology 7214352863 Reassigns benefits to 2 organizations
I20240402002309 CA Practitioner - Diagnostic Radiology 7214352863 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Southern California Keck School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sonoran Radiology LTDGroup PAC ID 3375964505, 466 clinicians
Southwest Diagnostic Imaging LLCGroup PAC ID 7416946199, 121 clinicians

Practice addresses (Care Compare)

10230 W Happy Valley Pkwy
Suite 100
Peoria, AZ 85383-4255
Phone (832) 915-2534

1515 E Bethany Home Rd
Phoenix, AZ 85014-2495
Phone (832) 915-2534

19829 N 27TH Ave
Phoenix, AZ 85027-4001
Phone (832) 915-2534

2050 W Southern Ave
Apache Junction, AZ 85120-7305
Phone (832) 915-2534

250 E Dunlap Ave
Phoenix, AZ 85020-2825
Phone (832) 915-2534

33400 N 32ND Ave
Phoenix, AZ 85085-8876
Phone (832) 915-2534

3648 W Anthem Way
Suite A100
Anthem, AZ 85086-7002
Phone (832) 915-2534

5330 S Hwy 95
Fort Mohave, AZ 86426-9225
Phone (832) 915-2534

6220 W Bell Rd
Suite 110
Glendale, AZ 85308-3896
Phone (832) 915-2534

6750 E Baywood Ave
Mesa, AZ 85206-1749
Phone (832) 915-2534

7400 E Osborn Rd
Scottsdale, AZ 85251-6432
Phone (832) 915-2534

7400 E Thompson Peak Pkwy
Scottsdale, AZ 85255-4109
Phone (832) 915-2534

9003 E Shea Blvd
Scottsdale, AZ 85260-6709
Phone (832) 915-2534

9017 Harvard Ave
Buena Park, CA 90620-4621
Phone (832) 915-2534

9220 E Mountain View Rd
Suite 100
Scottsdale, AZ 85258-5134
Phone (480) 425-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 127577FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sonoran Radiology LTD Diagnostic Radiology CurrentSince Jul 1, 2020 Accepting new patients
Southwest Diagnostic Imaging LLC Diagnostic Radiology CurrentSince Jul 1, 2020 Accepting new patients

Locations (25 of 49)

3648 W Anthem Way
Ste A100
Anthem, AZ 85086
Phone (623) 434-6444

2050 W Southern Ave
Apache Junction, AZ 85120
Phone (480) 237-3200

1800 E Florence Blvd
Casa Grande, AZ 85122
Phone (520) 381-6285

16838 E Palisades Blvd
Ste C151
Fountain Hills, AZ 85268

3645 S Rome St
Ste 101
Gilbert, AZ 85297

6220 W Bell Rd
Ste 110
Glendale, AZ 85308
Phone (602) 547-7230

1052 E McKellips Rd
Mesa, AZ 85203
Phone (480) 425-5080

1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000

6750 E Baywood Ave
Mesa, AZ 85206
Phone (480) 854-5000

10575 N Tatum Blvd
Ste C128
Paradise Vly, AZ 85253
Phone (480) 998-1490

807 S Ponderosa St
Payson, AZ 85541
Phone (520) 474-3222

10230 W Happy Valley Pkwy
Ste 100
Peoria, AZ 85383
Phone (623) 266-4699

9165 W Thunderbird Rd
Peoria, AZ 85381
Phone (623) 285-1120

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

1515 E Bethany Home Rd
Phoenix, AZ 85014
Phone (602) 812-3080

16641 N 40th St
Ste 1
Phoenix, AZ 85032
Phone (623) 931-7999

19636 N 27th Ave
Ste LL1
Phoenix, AZ 85027
Phone (602) 485-7482

19829 N 27th Ave
Phoenix, AZ 85027
Phone (602) 879-5720

20940 N Tatum Blvd
Ste 390
Phoenix, AZ 85050
Phone (480) 407-0060

2222 E Highland Ave
Ste 120
Phoenix, AZ 85016
Phone (602) 977-1177

2323 W Rose Garden Ln
Phoenix, AZ 85027
Phone (623) 931-7999

250 E Dunlap Ave
Phoenix, AZ 85020
Phone (480) 331-6721

33400 N 32nd Ave
Phoenix, AZ 85085
Phone (540) 998-0000

33423 N 32nd Ave
Phoenix, AZ 85085
Phone (623) 474-1600

8825 N 23rd Ave
Ste 100
Phoenix, AZ 85021
Phone 41550438389238

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1402790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463702400000",
    "number": "1639583974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-243-5512",
            "fax_number": "305-243-4613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-243-5512",
            "fax_number": "305-243-4613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAI",
        "first_name": "TIN",
        "middle_name": "TRUNG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-15",
        "last_updated": "2016-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME 127577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.