PHOENIX NEURODIAGNOSTICS, LLC (NPI# 1619364130) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619364130 |
| Entity Type | Organization |
| Organization Name | PHOENIX NEURODIAGNOSTICS, LLC |
| Practice Address |
64 E Broadway Rd Ste 202 Tempe AZ 85282-1377 |
| Mailing Address |
4545 Fuller Dr Ste 100 Irving TX 75038-6509 |
| Practice Telephone | 6023138626 |
| Practice Fax Number | 8662794704 |
| Mailing Telephone | 4699958416 |
| Mailing Fax Number | 8662794704 |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2020-10-12 |
| Authorized Official Name | CHARLES ALVAREZ (CEO) |
| Authorized Official Telephone | 4699958416 |
| Is Organization Subpart | Y |
| Parent Organization Name | ALLIANCE FAMILY OF COMPANIES, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities | ||
| N | 261QS1200X |
Clinic/Center Specialization: Sleep Disorder Diagnostic |
Ambulatory Health Care Facilities | ||
| Y | 293D00000X | Physiological Laboratory | Laboratories |
| Street Address |
64 E BROADWAY RD STE 202 |
| City | TEMPE |
| State | AZ |
| Zip Code | 85282-1377 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346893575 | Cactus Canyon Dental | Dentist | 2043 E Southern Ave, Ste. C, Tempe, AZ 85282 | 2019-07-17 |
| 1023679644 | Donna Cooks | Registered Nurse | 233 E. Sourthern Ave #27702, Tempe, AZ 85282 | 2019-06-25 |
| 1841854932 | Lynn Stafford | Registered Nurse | 4041 S. Mcclintock, Ste 302, Tempe, AZ 85282 | 2019-04-24 |
| 1598227340 | Jane Ramenofsky Ramenofsky Stewart | Registered Nurse | 4041 So. Mcclintock Suite 302, Tempe, AZ 85282 | 2019-04-02 |
| 1588129902 | Mary K Wheeler Mcfarland | Registered Nurse | Adobe Care and Wellness LLC, Address Is 4041 S. Mcclintock, Ste 302, Tempe, AZ 85282 | 2019-02-11 |
| 1669949780 | Crestview Pharmacy Services LLC | Pharmacy | 3225 South Hardy Dr., Ste 100, Tempe, AZ 85282 | 2018-10-26 |
| 1275018715 | Berlin Wright | Naturopath | 2164 E. Broadway Rd., Tempe, AZ 85282 | 2018-10-01 |
| 1043701543 | Lakeshore Interventional Treatment Center LLC | Surgery | 4765 S Lakeshore Dr, Tempe, AZ 85282 | 2018-05-21 |
| 1427553940 | The Bridge Counseling, Consulting and Mediation LLC | Counselor | 4625 S. Lakeshore Dr., 302, Tempe, AZ 85282 | 2018-03-27 |
| 1346741501 | Coraesthetics Pllc | Physician Assistant | 2008 E Laguna Dr, Tempe, AZ 85282 | 2018-02-23 |
| Find all providers in zip 85282 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1386963924 | Insight Health Corp. | Physiological Laboratory | 10249 W. Thunderbird Rd, Suite 200, Sun City, AZ 85351 | 2010-05-21 |
| 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 |
| 1609834159 | Sunrise Medical Diagnostic, Inc | Physiological Laboratory | 12611 N 103rd Ave, Ste # G, Sun City, AZ 85351-3422 | 2006-05-03 |
| 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.