Individual provider Active NPI

Smita Sane Bailey, MD

  • Pediatric Radiology Physician
  • Phoenix, AZ
National Provider Identifier
1972559946
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
42489 Issued in AZ
Practice address
1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone
(602) 933-1213
Fax
(602) 933-1214
NPI assigned
May 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology Physician 2085P0229X 40430 WI
Pediatric Radiology Physician 2085P0229X G87591 CA
Pediatric Radiology Physician 2085P0229X 42489 AZ Primary

Addresses

Primary practice location

1919 E Thomas Rd
Phoenix, AZ 85016-7710

Mailing address

3200 E Camelback Rd Ste 250
Phoenix, AZ 85018-2327
Phone (602) 933-1813

Other practice location 1

5131 E Southern Ave
Mesa, AZ 85206-2799
Phone (480) 833-5437

Other practice location 2

5131 E Southern Ave
Mesa, AZ 85206-2799
Phone (480) 833-5437

Other identifiers 2

IdentifierTypeStateIssuer
00G875910MedicaidCA
491321MedicaidAZ

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100716000007 AZ Practitioner - Diagnostic Radiology 6709818123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Minnesota Medical School, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Children'S HospitalGroup PAC ID 0446278584, 431 clinicians

Practice addresses (Care Compare)

1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone (602) 933-0930

Hospital & facility affiliations

  • Phoenix Children'S Hospital Hospital, Phoenix, AZ, CCN 033302

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G87591CAMDPediatric Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Children'S Medical Group CurrentSince May 16, 2010 Accepting new patients
Phoenix Children'S Hospital CurrentSince May 16, 2010 Accepting new patients
Simonmed Imaging, Incorporated Diagnostic Radiology Past Accepting new patients
Smi Imaging, LLC Diagnostic Radiology Past Accepting new patients
Pediatric Radiologic Services SC Diagnostic Radiology Past Accepting new patients
Phoenix Children'S Hospital Hope Past Accepting new patients
Smi Imaging, LLC Diagnostic Radiology Past Accepting new patients
Smi Imaging LLC Diagnostic Radiology Past Accepting new patients

Locations

1665 N Avondale Blvd
Avondale, AZ 85392
Phone (602) 933-0005

3555 S Val Vista Dr
Gilbert, AZ 85297
Phone (480) 434-4356

19007 N 67th Ave
Glendale, AZ 85308
Phone (602) 933-0777

20325 N 51st Ave
Ste 116
Glendale, AZ 85308
Phone (602) 933-1010

6524 W Sack Dr
Ste 130
Glendale, AZ 85308

5131 E Southern Ave
Mesa, AZ 85206
Phone (480) 833-5437

1919 E Thomas Rd
Bldg 2108
Phoenix, AZ 85016
Phone (602) 512-8030

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

3200 E Camelback Rd
Ste 250
Phoenix, AZ 85018
Phone (602) 933-1814

6990 E Shea Blvd
Ste 104
Scottsdale, AZ 85254

Organizations & group practices 8

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1972559946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 E CAMELBACK RD STE 250",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182327",
            "telephone_number": "602-933-1813",
            "fax_number": "602-933-1820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-933-1213",
            "fax_number": "602-933-1214"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5131 E Southern Ave",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852062799",
            "country_code": "US",
            "telephone_number": "480-833-5437",
            "fax_number": "480-833-9349",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5131 E Southern Ave",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852062799",
            "country_code": "US",
            "telephone_number": "480-833-5437",
            "fax_number": "480-833-9349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "SMITA",
        "middle_name": "SANE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "WI",
            "license": "40430",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "CA",
            "license": "G87591",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "AZ",
            "license": "42489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G875910",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "491321",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.