NPIMap

Organization Active NPI

Kan-Di-Ki LLC

  • Diagnostic Ultrasound Physician
  • Phoenix, AZ
National Provider Identifier
1992017529
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Ultrasound PhysicianTaxonomy code 2085U0001X
Legal business name
KAN-DI-KI LLC
Practice address
2502 E University Dr Ste 290
Phoenix, AZ 85034-6932
Phone
(602) 281-4225
Fax
(443) 842-7264
NPI assigned
Jul 12, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Authorized official

Name
Brian C Cuomo
Title
Authorized Official/Cfo
Phone
(800) 786-8015

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Ultrasound PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085U0001X Primary

Addresses

Primary practice location

2502 E University Dr Ste 290
Phoenix, AZ 85034-6932

Mailing address

215 Schilling Cir Ste 114
Hunt Valley, MD 21031-1113
Phone (800) 786-8015

Other practice location 1

7355 Prairie Falcon Rd
Las Vegas, NV 89128-0801
Phone (702) 589-9795

Other identifiers 4

IdentifierTypeStateIssuer
517185MedicaidAZ
Z144027OtherAZMEDICARE
P01005658OtherAZRAIL ROAD MEDICARE
633245MedicaidAZ

Other names 2

  • Diagnostic Laboratories Doing business as
  • TridentCare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110322000089 AZ Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 5991737140 Receives reassigned benefits from 1 practitioner
Practice locations: Phoenix, AZ

Other NPIs with the same Medicare PAC ID 12

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Diagnostic Xray17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Locations

3230 E Broadway Rd
Ste 100
Phoenix, AZ 85040
Phone (480) 967-2281

Practitioners & affiliated clinicians

Practitioners 53

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

View all 53

NPI Registry JSON

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

{
    "created_epoch": "1278892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773187200000",
    "number": "1992017529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 SCHILLING CIR STE 114",
            "city": "HUNT VALLEY",
            "state": "MD",
            "postal_code": "210311113",
            "telephone_number": "800-786-8015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2502 E UNIVERSITY DR STE 290",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850346932",
            "telephone_number": "602-281-4225",
            "fax_number": "443-842-7264"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7355 Prairie Falcon Rd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891280801",
            "country_code": "US",
            "telephone_number": "702-589-9795",
            "fax_number": "443-842-7264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KAN-DI-KI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-12",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A",
        "authorized_official_last_name": "CUOMO",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL/CFO",
        "authorized_official_telephone_number": "800-786-8015"
    },
    "taxonomies": [
        {
            "code": "2085U0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "517185",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "Z144027",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P01005658",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "633245",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diagnostic Laboratories",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Diagnostic Laboratories",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TridentCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; 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.