NPIMap

Organization Active NPI

Equality Medical Group LLC

  • Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1770148322
Registry record updated Sep 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
EQUALITY MEDICAL GROUP LLC
Practice address
9020 W Thomas Rd
Phoenix, AZ 85037-3234
Phone
(580) 686-0282
NPI assigned
May 8, 2019
Last updated
Sep 25, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2020

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

Authorized official

Name
Rose Mata-Espinoza
Title
Credentialing Coordinator
Phone
(602) 687-8219

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

9020 W Thomas Rd
Phoenix, AZ 85037-3234

Mailing address

4220 N 20TH Ave
Phoenix, AZ 85015-5124
Phone (602) 889-9401

Other identifiers 1

IdentifierTypeStateIssuer
530088MedicaidAZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 22

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 22

NPI Registry JSON

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

{
    "created_epoch": "1557273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600992000000",
    "number": "1770148322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 N 20TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850155124",
            "telephone_number": "602-889-9401",
            "fax_number": "602-889-9404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9020 W THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850373234",
            "telephone_number": "580-686-0282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EQUALITY MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-08",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A",
        "authorized_official_last_name": "MATA-ESPINOZA",
        "authorized_official_first_name": "ROSE",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "602-687-8219"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "530088",
            "state": "AZ"
        }
    ],
    "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 Sep 25, 2020; 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.