NPIMap

Organization Active NPI

Afc Physical Medicine of Desert Ridge,PLLC

  • Physical Medicine & Rehabilitation Physician
  • Phoenix, AZ
National Provider Identifier
1669731303
Registry record updated Dec 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
AFC PHYSICAL MEDICINE OF DESERT RIDGE,PLLC
Practice address
20860 N Tatum Blvd
Suite 290
Phoenix, AZ 85050-4274
Phone
(480) 563-1144
Fax
(480) 563-2371
NPI assigned
May 15, 2012
Last updated
Dec 8, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2017

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

Authorized official

Name
Joshua F. BockNPI 1275532814
Title
Managing Member
Phone
(480) 726-2287

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 7057360001 AZ
Physical Medicine & Rehabilitation Physician 208100000X NU Primary

Addresses

Primary practice location

20860 N Tatum Blvd
Suite 290
Phoenix, AZ 85050-4274

Mailing address

1839 S Alma School Rd Ste 354
Mesa, AZ 85210-3028
Phone (480) 726-2287

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20121017000609 AZ Part B Supplier - Clinic/Group Practice 6507016169 Receives reassigned benefits from 66 practitioners
Practice locations: Phoenix, AZ
O20140411001651 AZ DME Supplier - Multi-Specialty - Physician 6507016169 Practice locations: Phoenix, AZ

National Provider Directory

National Provider Directory

Locations

20830 N Tatum Blvd
Ste 210
Phoenix, AZ 85050
Phone (480) 563-1144

20830 N Tatum Blvd
Ste 290
Phoenix, AZ 85050

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 68

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 68

NPI Registry JSON

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

{
    "created_epoch": "1337040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512691200000",
    "number": "1669731303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 S ALMA SCHOOL RD STE 354",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852103028",
            "telephone_number": "480-726-2287",
            "fax_number": "888-316-9272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20860 N TATUM BLVD",
            "address_2": "SUITE 290",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850504274",
            "telephone_number": "480-563-1144",
            "fax_number": "480-563-2371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFC PHYSICAL MEDICINE OF DESERT RIDGE,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-15",
        "last_updated": "2017-12-08",
        "status": "A",
        "authorized_official_last_name": "BOCK",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "480-726-2287"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "7057360001",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "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 Dec 8, 2017; 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.