NPIMap

Organization Active NPI

Matrix Medical Network of West

Doing business as Matrix Medical Network

  • Nurse Practitioner
  • Scottsdale, AZ
National Provider Identifier
1942569033
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
MATRIX MEDICAL NETWORK OF WEST
Doing business as
Matrix Medical Network
Practice address
9201 E Mountain View Rd
Suite 220
Scottsdale, AZ 85258
Phone
(480) 862-1700
Fax
(877) 506-4560
NPI assigned
May 9, 2012
Last updated
Feb 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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

Authorized official

Name
Justin Pham, MDNPI 1821040866
Title
PC Owner
Phone
(877) 564-3627

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

9201 E Mountain View Rd
Suite 220
Scottsdale, AZ 85258

Mailing address

9201 E Mountain View Rd
Suite 220
Scottsdale, AZ 85258-5199
Phone (480) 862-1700

Other names 1

  • Matrix Medical Network Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171212001076 WV Part B Supplier - Clinic/Group Practice 0244598621 Receives reassigned benefits from 68 practitioners
Practice locations: Charleston, WV

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 70

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.

View all 70

NPI Registry JSON

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

{
    "created_epoch": "1336521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645401600000",
    "number": "1942569033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9201 E MOUNTAIN VIEW RD",
            "address_2": "SUITE 220",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852585199",
            "telephone_number": "480-862-1700",
            "fax_number": "877-506-4560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9201 E MOUNTAIN VIEW RD",
            "address_2": "SUITE 220",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "85258",
            "telephone_number": "480-862-1700",
            "fax_number": "877-506-4560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATRIX MEDICAL NETWORK OF WEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-09",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "PC OWNER",
        "authorized_official_telephone_number": "877-564-3627",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Matrix Medical Network",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.