Active NPI
Mark Sundell, DO
- Diagnostic Radiology Physician
- Globe, AZ
National Provider Identifier
1962616151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 3290
- Practice address
- 5880 S Hospital Dr
Globe, AZ 85501-9447 - Phone
- (469) 757-1120
- NPI assigned
- May 9, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 3290 | AZ | Primary |
Addresses
Primary practice location
5880 S Hospital Dr
Globe, AZ 85501-9447
Mailing address
PO Box 53519
Phoenix, AZ 85072-3519
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 116317 | Other | AZ | MEDICARE |
| 116318 | Other | AZ | MEDICARE |
| 116319 | Other | AZ | MEDICARE |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3290 | AZ | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| College Street Medical Group, P.L.L.C. | Past | Accepting new patients | |
| Gila County Radiology PLLC | Diagnostic Radiology | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Diagnostic Radiology Physician
- Globe, AZ
- NPI 1073716791
-
- Family Medicine Physician
- Beaumont, TX
- NPI 1912233289
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188172800000",
"number": "1962616151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 53519",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850723519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5880 S HOSPITAL DR",
"city": "GLOBE",
"state": "AZ",
"postal_code": "855019447",
"telephone_number": "469-757-1120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUNDELL",
"first_name": "MARK",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-09",
"last_updated": "2007-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "AZ",
"license": "3290",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "116317",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "116318",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "116319",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Globe, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.