SUNRISE MEDICAL DIAGNOSTIC, INC (NPI# 1609834159) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609834159 |
| Entity Type | Organization |
| Organization Name | SUNRISE MEDICAL DIAGNOSTIC, INC |
| Practice Address |
12611 N 103rd Ave Ste # G Sun City AZ 85351-3422 |
| Practice Telephone | 6239724125 |
| Practice Fax Number | 6239720265 |
| Mailing Telephone | 6239724125 |
| Mailing Fax Number | 6239720265 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MARINA KOKHAN (PRESIDENT) |
| Authorized Official Telephone | 6239724125 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 293D00000X | Physiological Laboratory | Laboratories |
| Street Address |
12611 N 103RD AVE STE # G |
| City | SUN CITY |
| State | AZ |
| Zip Code | 85351-3422 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760699276 | Monte R Bosch | Dentist | 12611 N 103rd Ave, Suite B, Sun City, AZ 85351-3422 | 2007-05-16 |
| 1588795777 | Mary T A Spohn-carle | Acupuncturist | 12611 N 103rd Ave, Suite A, Sun City, AZ 85351-3422 | 2007-03-08 |
| 1003862681 | Med Help Medical Supplies | Durable Medical Equipment & Medical Supplies | 12611 N 103rd Ave, Suite 'd', Sun City, AZ 85351-3422 | 2006-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467003566 | T&h Hearing LLC | Hearing Aid Equipment | 13616 N. 99th Ave., Sun City, AZ 85351 | 2019-09-20 |
| 1881247682 | Amanda M Neri | Physician Assistant | 10401 W. Thunderbird Blvd Md Anderson - Banner Boswell, Sun City, AZ 85351 | 2019-07-20 |
| 1649822313 | Azmed Rehab LLC | Family Medicine | 14281 North Del Webb Blvd, Sun City, AZ 85351 | 2019-07-12 |
| 1982182267 | Akdhc, LLC | Internal Medicine | 10249 W Thunderbird Blvd Ste 100, Sun City, AZ 85351 | 2018-07-30 |
| 1871084814 | Amy Mikulec | Physical Therapist | Banner Physical Therapy and Rehab Boswell, 10503 W Thunderbird Blvd Suite 263a, Sun City, AZ 85351 | 2018-05-25 |
| 1194238345 | Lorie Jo Matthews | Nurse Practitioner | 10494 W Thunderbird Blvd Ste 102, Sun City, AZ 85351 | 2017-11-09 |
| 1184153363 | Susan Jane Hockman | Registered Nurse | 14601 N Delwebb Blvd, Sun City, AZ 85351 | 2017-06-09 |
| 1043769169 | Medsource Orthotics & Prosthetics, Inc | Prosthetic/Orthotic Supplier | 13203 N 103rd Ave Ste J1&j2, Sun City, AZ 85351 | 2016-09-30 |
| 1033563002 | Vittoria Giovannucci | Technician/Technologist | 10503 W Thunderbird Blvd Ste 101a, Sun City, AZ 85351 | 2016-04-15 |
| 1669858379 | Qui Nguyen | Pharmacist | 10660 Nw Grand Ave, Sun City, AZ 85351 | 2015-08-04 |
| Find all providers in zip 85351 | ||||
| Taxonomy Code | 293D00000X |
| Grouping | Laboratories |
| Classification | Physiological Laboratory |
| A laboratory that operates independently of a hospital and physician’s office to furnish physiological diagnostic services (e.g. EEG’s , EKG’s, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services. |
| Notes: Source: Paraphrased from the Medicare Carrier Manual, Section 2070.5. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386021608 | Melissa Alvarez | Physiological Laboratory | 26118 Crestmont Cir, Sun City, CA 92586-5813 | 2015-05-06 |
| 1386963924 | Insight Health Corp. | Physiological Laboratory | 10249 W. Thunderbird Rd, Suite 200, Sun City, AZ 85351 | 2010-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952803652 | Comfort Care Providers, LLC. | Physiological Laboratory | 555 E Plaza Cir Dr Ste C, Litchfield Park, AZ 85340 | 2018-03-08 |
| 1518472950 | Tri-state Medical Alliance, LLC | Physiological Laboratory | 1510 E Wagon Wheel Ln Ste 103, Fort Mohave, AZ 86426-6698 | 2017-12-07 |
| 1659793180 | Dermspectra, LLC | Physiological Laboratory | 2601 N Campbell Ave, Suite 205, Tucson, AZ 85719-3163 | 2014-01-17 |
| 1871921189 | Omniwest, LLC | Physiological Laboratory | 4647 E Laredo Ln, Cave Creek, AZ 85331-5062 | 2013-10-23 |
| 1932435526 | Insight Health Corp. | Physiological Laboratory | 5040 N. 15th Ave., Suite 101, Phoenix, AZ 85015-3328 | 2009-11-02 |
| 1740478072 | Az Neuromonitoring LLC | Physiological Laboratory | 10105 E Via Linda, Ste 103-274, Scottsdale, AZ 85258-5311 | 2007-10-11 |
| 1598891582 | Health Care Imaging Inc | Physiological Laboratory | 202 E Earll Dr Ste 190, Phoenix, AZ 85012 | 2007-02-26 |
| 1770504870 | Mohave Medical Imaging Center | Physiological Laboratory | 1851 Mesquite Ave, Suite 112, Lake Havasu City, AZ 86403-5677 | 2006-07-22 |
| 1659330710 | Insight Health Corp | Physiological Laboratory | 2921 N 18th Pl, Phoenix, AZ 85016-7705 | 2006-03-18 |
| 1558330977 | Insight Health Corp | Physiological Laboratory | 10595 N Tatum Blvd, Ste E144, Paradise Valley, AZ 85253-1071 | 2006-03-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.