Organization Active NPI

Cardiovascular Lab of Arizona LLC

  • Interventional Cardiology Physician
  • Scottsdale, AZ
National Provider Identifier
1770154767
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
Legal business name
CARDIOVASCULAR LAB OF ARIZONA LLC
Practice address
16638 N 90TH St Ste 101
Scottsdale, AZ 85260-1539
Phone
(480) 747-6532
NPI assigned
Jul 9, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Authorized official

Name
Nassim Haddad, MDNPI 1316060619
Title
Member Manager
Phone
(480) 747-6532

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0011X Primary

Addresses

Primary practice location

16638 N 90TH St Ste 101
Scottsdale, AZ 85260-1539

Mailing address

16638 N 90TH St Ste 101
Scottsdale, AZ 85260-1539
Phone (480) 506-0484

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211018002587 AZ Part B Supplier - Clinic/Group Practice 1850799131 Receives reassigned benefits from 3 practitioners
Practice locations: Scottsdale, AZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1625788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777248000000",
    "number": "1770154767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16638 N 90TH ST STE 101",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852601539",
            "telephone_number": "480-506-0484",
            "fax_number": "480-944-2141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16638 N 90TH ST STE 101",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852601539",
            "telephone_number": "480-747-6532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOVASCULAR LAB OF ARIZONA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-09",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A",
        "authorized_official_last_name": "HADDAD",
        "authorized_official_first_name": "NASSIM",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "480-747-6532",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2026; 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.