Portable X Ray of Arizona LLC

Primary specialty

Diagnostic Ultrasound PhysicianTaxonomy code 2085U0001X

Legal business name

PORTABLE X RAY OF ARIZONA LLC

Practice address

2338 W Royal Palm Rd
Phoenix, AZ 85021-9339

Phone

(602) 864-3656

Fax

(602) 864-3660

NPI assigned

Mar 13, 2007

Organization subpart

No

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

Authorized official

Name

Abby Grossa

Title

Cfo

Phone

(702) 395-5011

Specialties & licenses 1

Addresses

Other identifiers 8

Locations

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195084800000",
    "number": "1659404176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5538 DUNCAN DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891302812",
            "telephone_number": "702-395-5011",
            "fax_number": "702-645-2874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2338 W ROYAL PALM RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850219339",
            "telephone_number": "602-864-3656",
            "fax_number": "602-864-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTABLE X RAY OF ARIZONA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-11-15",
        "status": "A",
        "authorized_official_last_name": "GROSSA",
        "authorized_official_first_name": "ABBY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "702-395-5011"
    },
    "taxonomies": [
        {
            "code": "2085U0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCS",
            "identifier": "579055",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCHOICE",
            "identifier": "579055",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "AW2888",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHOENIX HEALTH PLAN",
            "identifier": "F10081",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "2Z1598",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "579055",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SCAN",
            "identifier": "67270",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHILED OF",
            "identifier": "AZ0890990",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Enriqueta M Porras, M.D.
• Misael Porras
• Vanessa Porras, FNP-C
• Portable Imaging of Arizona, LLC
• Portable X Ray of Arizona LLC
• Portable Xray of Arizona Phoenix
• Breanna Portale
• Melissa Portela, A.T.
• Victoria Porten
• Kelley Roxanne Porter Turner, LMSW

• Diagnostic Ultrasound Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Diagnostic Ultrasound Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.