Individual provider Active NPI

Samuel Puentes, RT (ARRT)

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Somerton, AZ
National Provider Identifier
1902608037
Registry record updated Mar 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X
License
CRT-71133 Issued in AZ
Practice address
PO Box 3818
Somerton, AZ 85350-3818
Phone
(928) 285-7857
NPI assigned
Mar 27, 2025
Last updated
Mar 29, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 335V00000X CRT-71133 AZ Primary

Addresses

Primary practice location

PO Box 3818
Somerton, AZ 85350-3818

Mailing address

PO Box 3818
Somerton, AZ 85350-3818
Phone (928) 285-7857

Other practice location 1

762 E Angelica St
PO Box 3818
Somerton, AZ 85350
Phone (928) 285-7857

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CRT-71133AZMDPortable X-ray and/or Other Portable Diagnostic Imaging Supplier

Practice roles

OrganizationSpecialtyStatusNew patients
X Mobile X Ray Inc Portable X-Ray and/Or Other Portable Diagnostic Imaging Supplier CurrentSince Apr 6, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1743033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743206400000",
    "number": "1902608037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3818",
            "city": "SOMERTON",
            "state": "AZ",
            "postal_code": "853503818",
            "telephone_number": "928-285-7857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 3818",
            "city": "SOMERTON",
            "state": "AZ",
            "postal_code": "853503818",
            "telephone_number": "928-285-7857"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "762 E Angelica St",
            "address_2": "PO BOX 3818",
            "address_purpose": "LOCATION",
            "city": "Somerton",
            "state": "AZ",
            "postal_code": "85350",
            "country_code": "US",
            "telephone_number": "928-285-7857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUENTES",
        "first_name": "SAMUEL",
        "credential": "RT (ARRT)",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-27",
        "last_updated": "2025-03-29",
        "certification_date": "2025-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": "AZ",
            "license": "CRT-71133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerton, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2025; 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.