NPIMap

Organization Active NPI

Surgical Professionals, Inc

  • Surgery Physician
  • Mesa, AZ
National Provider Identifier
1982629978
Registry record updated May 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
22813 Issued in AZ
Legal business name
SURGICAL PROFESSIONALS, INC
Practice address
4135 S Power Rd
Suite 117
Mesa, AZ 85212-3624
Phone
(480) 545-2610
Fax
(480) 545-2673
NPI assigned
Jul 12, 2006
Last updated
May 27, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2016

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

Authorized official

Name
Dr. Devin L Gray, MDNPI 1134154941
Title
Owner
Phone
(480) 202-0604

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
Surgery Physician 208600000X 22813 AZ Primary

Addresses

Primary practice location

4135 S Power Rd
Suite 117
Mesa, AZ 85212-3624

Mailing address

2558 S Riata CT
Gilbert, AZ 85295-5948
Phone (480) 202-0604

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040326001134 AZ Part B Supplier - Clinic/Group Practice 7012809775 Receives reassigned benefits from 2 practitioners
Practice locations: Chandler, AZ; Mesa, AZ; Queen Creek, AZ

National Provider Directory

National Provider Directory

Locations

1501 N Gilbert Rd
Ste 130
Gilbert, AZ 85234
Phone (480) 505-3276

Practitioners & affiliated clinicians

Practitioners 21

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 21

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464307200000",
    "number": "1982629978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2558 S RIATA CT",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852955948",
            "telephone_number": "480-202-0604",
            "fax_number": "480-892-2458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4135 S POWER RD",
            "address_2": "SUITE 117",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852123624",
            "telephone_number": "480-545-2610",
            "fax_number": "480-545-2673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL PROFESSIONALS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2016-05-27",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "DEVIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-202-0604",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "22813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2016; 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.