Andrew Poulos, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

15512 Issued in AZ

Practice address

15810 S 45TH St Ste 110
Phoenix, AZ 85048-7695

Phone

(480) 763-7273

NPI assigned

Jan 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

79.36 of 100Reported as group

Quality

75.71

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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

• Smi Imaging, LLC

  • Diagnostic Radiology Physician
  • Scottsdale, AZ
  • NPI 1972004489
  Medicare reassignment NPD
• Cigna Health Care of Arizona Inc

  • Urgent Care Clinic/Center
  • Mesa, AZ
  • NPI 1467564302
  NPD
• Cigna Health Care of Arizona Inc.

  • Urgent Care Clinic/Center
  • Phoenix, AZ
  • NPI 1245338235
  NPD
• Cigna Health Care of Arizona Inc.

  • Multi-Specialty Clinic/Center
  • Tempe, AZ
  • NPI 1649341298
  NPD
• Cigna Health Care of Arizona Inc.

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1942371679
  NPD
• Cigna Healthcare of Arizona, Inc.

  • Multi-Specialty Clinic/Center
  • Scottsdale, AZ
  • NPI 1073626404
  NPD
• Cigna Healthcare of Arizona, Inc.

  • Multi-Specialty Clinic/Center
  • Mesa, AZ
  • NPI 1790950988
  NPD

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1912977992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7416 E PALO VERDE DR",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852506030",
            "telephone_number": "480-888-6248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15810 S 45TH ST STE 110",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487695",
            "telephone_number": "480-763-7273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULOS",
        "first_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "15512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171281",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jack Potts X, M.D.
• James Potts
• Amanda Potucek, NP
• Jessica M Potvin, PHD
• Mark J Poulin, NP
• Callie Jordan Poulos, SLPL
• Maria Lyn C Poulson, DC
• Zachary Daniel Poulter
• Ernest I Pouncy, GUIDANCE COUNSELOR
• Pejman Pourarbab, D.C

• Diagnostic Radiology Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Diagnostic Radiology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.