NPIMap

Organization Active NPI

Effideen Ameerally MD PC

  • Family Medicine Physician
  • Mesa, AZ
National Provider Identifier
1891740296
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
17561 Issued in AZ
Legal business name
EFFIDEEN AMEERALLY MD PC
Practice address
7436 E Main St
Ste 2
Mesa, AZ 85207-8338
Phone
(480) 325-9600
Fax
(480) 907-2355
NPI assigned
May 23, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. Amit Patel, MDNPI 1811153604
Title
Owner
Phone
(405) 921-2503

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Practitioners 43

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

View all 43

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
03D1059705Medical Clinic,the7436 E Main St Ste 2, Mesa, AZ 85207Certificate of waiverOct 3, 2026

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20040610001407 AZ Part B Supplier - Clinic/Group Practice 2264415108 Receives reassigned benefits from 38 practitioners
Practice locations: Mesa, AZ; Prescott, AZ; Scottsdale, AZ

National Provider Directory

National Provider Directory

Locations

100 W Apache Trl
Ste 8
Apache Junction, AZ 85120
Phone (480) 288-7700

7436 E Main St
Mesa, AZ 85207
Phone (480) 832-2600

8897 E Desert CV Ave
1St FL
Scottsdale, AZ 85260

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 17561 AZ Primary
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X 17561 AZ

Addresses

NPPES NPI Registry

Primary practice location

7436 E Main St
Ste 2
Mesa, AZ 85207-8338

Mailing address

7436 E Main St Ste 2
Mesa, AZ 85207-9338
Phone (480) 325-9600

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
496178MedicaidAZ

Other names 1

NPPES NPI Registry
  • THE MEDICAL CLINIC Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 2, 2022.

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662076800000",
    "number": "1891740296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7436 E MAIN ST STE 2",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852079338",
            "telephone_number": "480-325-9600",
            "fax_number": "480-712-4948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7436 E MAIN ST",
            "address_2": "STE 2",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852078338",
            "telephone_number": "480-325-9600",
            "fax_number": "480-907-2355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EFFIDEEN AMEERALLY MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "AMIT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-921-2503",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "17561",
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "AZ",
            "license": "17561",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "496178",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "THE MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 2, 2022; 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.