NPIMap

Organization Active NPI

Select Specialty Hospital - Arizona Inc

Doing business as Select Specialty Hospital - Arizona

  • Long Term Care Hospital
  • Phoenix, AZ
National Provider Identifier
1902802861
Registry record updated Jan 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care HospitalTaxonomy code 282E00000X
License
SH2354 Issued in AZ
Legal business name
SELECT SPECIALTY HOSPITAL - ARIZONA INC
Doing business as
Select Specialty Hospital - Arizona
Practice address
1111 E McDowell Rd FL 11
Phoenix, AZ 85006-2612
Phone
(480) 675-6016
NPI assigned
Jun 24, 2005
Last updated
Jan 8, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2026

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

Authorized official

Name
Mr. John Duggan
Title
Vice President
Phone
(717) 972-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Hospital 282E00000X SH2354 AZ Primary

Addresses

Primary practice location

1111 E McDowell Rd FL 11
Phoenix, AZ 85006-2612

Mailing address

4714 Gettysburg Rd
Legal Dept.
Mechanicsburg, PA 17055-4325
Phone (717) 972-1100

Other identifiers 7

IdentifierTypeStateIssuer
707721MedicaidAZ
AZ0208080OtherAZBCBS AZ (SCOTTSDALE)
707739MedicaidAZ
486028MedicaidAZ
IZ0120OtherAZHEALTHNET
AZ0207750OtherAZBCBS AZ
AZ0208070OtherAZBCBS AZ (PHOENIX DTOWN)

Other names 1

  • Select Specialty Hospital - Arizona Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040412001296 AZ Part A Provider - Hospital 1355335431 Practice locations: Phoenix, AZ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902802861. Details of each certification follow.

Hospital certification: CCN 032005

Legal name
SELECT SPECIALTY HOSPITAL - ARIZONA INC
Doing business as
SELECT SPECIALTY HOSPITAL-ARIZONA
Certification status
Active
Provider type (POS)
Hospital – Long-term
Participating since
Jun 1, 2000
Last certification
Nov 4, 2017
Beds
62
Ownership / control type
Private (for profit)
Organization structure
CorporationProprietary
Incorporated
Nov 12, 1998 in DE
Enrollment address
1111 E McDowell Rd
FL 11
Phoenix, AZ 85006-2612
Main/Primary Hospital Location
Hospital subgroups
Long-term

Care Compare: Long-term care hospital

Medicare Care Compare
Listed as
Select Specialty Hospital ArizonaCCN 032005 · All quality measures
Ownership
For profit
Certified
Jun 1, 2000
Medicare certification status
ActiveFrom the Provider of Services file
Beds
62

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
03D0994099Select Specialty Hospital - Arizona, Inc1111 E McDowell Rd, 11TH Floor, Phoenix, AZ 85006Certificate of waiverOct 5, 2026

National Provider Directory

National Provider Directory
Tax ID family
Select Specialty Hospital - Arizona Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1012 E Willetta St
#4
Phoenix, AZ 85006
Phone (602) 239-6073

7400 E Osborn Rd
Fl 3
Scottsdale, AZ 85251
Phone (480) 675-6016

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Select Medical Corporation Organization, Mechanicsburg, PA For-profit 5% Or Greater Indirect Ownership Interest Dec 10, 1996 100%
Operational/Managerial Control Dec 10, 1996 100%
Thomas Mullin Individual Corporate Officer Sep 3, 2025
Intensiva Healthcare Corporation Organization, Mechanicsburg, PA Corporation, For-profit 5% Or Greater Direct Ownership Interest Jan 1, 2023 100%
Etene Terrell-Fakorede Individual Corporate OfficerCeo Sep 15, 2025
W-2 Managing EmployeeAd; Sep 15, 2025
Operational/Managerial ControlCeo Sep 15, 2025
John Saich Individual Corporate Officer Sep 3, 2025
Robert Breighner Individual W-2 Managing EmployeeCompliance Officer Sep 3, 2025
Michael Malatesta Individual Corporate Officer Sep 3, 2025
Robert Kido Individual Corporate Officer Sep 3, 2025
John Duggan Individual Corporate Officer Apr 12, 2004
Corporate Director Sep 3, 2025

Facilities with the same owner 129

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 129

Practitioners & affiliated clinicians

Practitioners 3

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.

Affiliated clinicians 5

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767830400000",
    "number": "1902802861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4714 GETTYSBURG RD",
            "address_2": "LEGAL DEPT.",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325",
            "telephone_number": "717-972-1100",
            "fax_number": "717-975-9981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 E MCDOWELL RD FL 11",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062612",
            "telephone_number": "480-675-6016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELECT SPECIALTY HOSPITAL - ARIZONA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-24",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A",
        "authorized_official_last_name": "DUGGAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "717-972-1100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "AZ",
            "license": "SH2354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "707721",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS AZ (SCOTTSDALE)",
            "identifier": "AZ0208080",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "707739",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "486028",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "IZ0120",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS AZ",
            "identifier": "AZ0207750",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS AZ (PHOENIX DTOWN)",
            "identifier": "AZ0208070",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Select Specialty Hospital - Arizona",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.