Organization Active NPI

Apex Internal Medicine, P.C.

  • Internal Medicine Physician
  • Mesa, AZ
National Provider Identifier
1841471141
Registry record updated Oct 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
22010 Issued in AZ
Legal business name
APEX INTERNAL MEDICINE, P.C.
Practice address
221 S Power Rd
Suite 104
Mesa, AZ 85206-5205
Phone
(480) 854-8780
Fax
(480) 854-8783
NPI assigned
Nov 15, 2007
Last updated
Oct 3, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2011

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

Authorized official

Name
Mr. Shaun Kanaka, MBA
Title
Billing Manager
Phone
(480) 225-3065

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 22010 AZ Primary

Addresses

Primary practice location

221 S Power Rd
Suite 104
Mesa, AZ 85206-5205

Mailing address

1463 W Heather Ave
Gilbert, AZ 85233-4126
Phone (480) 854-8780

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040712001076 AZ Part B Supplier - Clinic/Group Practice 5698753085 Receives reassigned benefits from 1 practitioner
Practice locations: Mesa, AZ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D1077822Apex Internal Medicine221 S Power Road Ste 104, Mesa, AZ 85206Certificate of waiverDec 18, 2027

National Provider Directory

National Provider Directory

Locations

221 S Power Rd
Ste 104
Mesa, AZ 85206
Phone (480) 854-8780

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317600000000",
    "number": "1841471141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1463 W HEATHER AVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852334126",
            "telephone_number": "480-854-8780",
            "fax_number": "480-854-8783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 S POWER RD",
            "address_2": "SUITE 104",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852065205",
            "telephone_number": "480-854-8780",
            "fax_number": "480-854-8783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APEX INTERNAL MEDICINE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-15",
        "last_updated": "2011-10-03",
        "status": "A",
        "authorized_official_last_name": "KANAKA",
        "authorized_official_first_name": "SHAUN",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "480-225-3065",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "22010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.