Physical Medicine of Mesa LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

PHYSICAL MEDICINE OF MESA LLC

Practice address

3614 E Southern Ave Ste 105
Mesa, AZ 85206-2510

Phone

(602) 354-5310

NPI assigned

Sep 22, 2020

Organization subpart

No

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

Authorized official

Name

Thomas Moshiri

Title

Manager

Phone

(602) 441-3573

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Tyler Church, M.D.

  • Anesthesiology Physician
  • Gilbert, AZ
  • NPI 1487837159
  NPD (past)

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

{
    "created_epoch": "1600732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645660800000",
    "number": "1952917205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21001 N TATUM BLVD STE 1630-606",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850504242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3614 E SOUTHERN AVE STE 105",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062510",
            "telephone_number": "602-354-5310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL MEDICINE OF MESA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-22",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A",
        "authorized_official_last_name": "MOSHIRI",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "602-441-3573"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phoenix Specialty Hospital
• Phoenix Vamc
• Phoenix Vascular Access, LLC
• Phusion Rehab
• Phylogenesis Financial Holdings LLC
• Physical Rehabilitation and Hand Centers Inc
• Physical Therapy Rehabilitation Specialists, PLLC
• Physician Group of Arizona Inc
• Physician Group of Arizona Inc
• Physiotherapy Associates Inc

• General Practice Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• General Practice Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; 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.