Andrew Poulos
Radiology (Diagnostic Radiology)

Address: 15810 S 45th St Ste 110, Phoenix, AZ 85048-7695
Phone: 4807637273

Andrew Poulos (NPI# 1912977992) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1912977992
Entity Type Individual
Full Name Andrew Poulos
Credential MD
Gender Male
Practice Address 15810 S 45th St Ste 110
Phoenix
AZ 85048-7695
Practice Telephone 4807637273
Mailing Address 7416 E Palo Verde Dr
Scottsdale
AZ 85250-6030
Mailing Telephone 4808886248
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2006-01-24
Last Update Date 2019-08-28

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 2085R0202X Radiology · Diagnostic Radiology Allopathic & Osteopathic Physicians 15512 AZ

Other Provider Identifier

State Identifier Issuer Type Code
AZ 171281 MEDICAID

Providers with the same name

NPI Name Taxonomy Address Enumeration
1760801120 Andrew Poulos Family Medicine 617 W Clairemont Ave, Eau Claire, WI 54701-6223 2014-04-15
1750318440 Andrew John Poulos Nurse Anesthetist, Certified Registered 667 Eastland Ave Se, Warren, OH 44484-4503 2006-06-27

Physician Overview

NPI 1912977992
PAC ID by PECOS 1759370604
Professional Enrollment ID I20040507000164
Full Name Andrew G Poulos
Organization Legal Name SMI IMAGING LLC
Phone Number 6022001750
Gender M
Credential MD
Medical School OHIO STATE UNIVERSITY COLLEGE OF MEDICINE
Graduation Year 1984
Primary Specialty DIAGNOSTIC RADIOLOGY
Group Practice PAC ID 3476696220
Number of Group Practice Members 128
Accepts Medicare Assignment Y

Taxonomy Information

Taxonomy Code 2085R0202X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Diagnostic Radiology

Taxonomy Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1649876806 Smi Imaging LLC Radiology 4045 E Bell Rd Ste 143, Phoenix, AZ 85032-2239 2020-12-11
1619573136 Smi Imaging LLC Radiology 2620 N 3rd St Ste 105, Phoenix, AZ 85004-1153 2020-12-09
1255937785 Smi Imaging LLC Radiology 5501 N 19th Ave Ste 111, Phoenix, AZ 85015-2451 2020-12-09
1811593338 Smi Imaging LLC Radiology 8921 W Thomas Rd Ste 101, Phoenix, AZ 85037-3244 2020-12-09
1659977130 Smi Imaging LLC Radiology 2502 E Camelback Rd Ste 167, Phoenix, AZ 85016-9316 2020-12-09
1831795756 Smi Imaging LLC Radiology 1110 E Missouri Ave Ste 410, Phoenix, AZ 85014-2704 2020-12-07
1932705878 Smi Imaging LLC Radiology 2141 E Camelback Rd Ste 110, Phoenix, AZ 85016-4723 2020-12-07
1851997761 Smi Imaging LLC Radiology 10240 W Indian School Rd Ste 145, Phoenix, AZ 85037-5907 2020-12-07
1598243867 Mdig of Florida, LLC Radiology 10835 N 25th Ave Ste 140, Phoenix, AZ 85029-3408 2018-07-30
1255870267 Smi Imaging, LLC Radiology 4219 E Bell Rd, Phoenix, AZ 85032-3366 2017-02-23
Find all providers in PHOENIX

Office Location

Street Address 15810 S 45TH ST STE 110
City PHOENIX
State AZ
Zip Code 85048-7695

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1164062618 Smile Dentistry Pllc Dentist 1238 E. Chandler Blvd. #101, Phoenix, AZ 85048 2020-01-13
1558924415 Ahwatukee Orthodontic Associates Inc Dentist 16611 S. 40th Street, Suite 110, Phoenix, AZ 85048 2019-04-17
1699299560 Brianna Alean Kinsey Student in an Organized Health Care Education/Training Program 16214 S. 1st Street, Phoenix, AZ 85048 2017-08-01
1497278113 Teague Duncan Wilson Specialist/Technologist 3305 E Nighthawk Way, Phoenix, AZ 85048 2017-07-25
1730550146 Jennifer Zazueta Physician Assistant 4126 E Nighthawk Way, Phoenix, AZ 85048 2015-10-12
1235551904 Louise Marie Braunbeck Physical Therapy Assistant 16649 S 24th Place, Phoenix, AZ 85048 2014-01-14
1780026260 Erin Onacki Social Worker 4530 E Muirwood Dr. Suite 103, Phoenix, AZ 85048 2013-07-24
1649528720 Cody A Morales Social Worker 4654 E Mountain Vista Dr, Phoenix, AZ 85048 2012-08-21
1417168287 Lori Lynn Haas Social Worker 4025 E. Chandler Boulevard, #70-e7, Phoenix, AZ 85048 2007-05-24
1285847210 Jonne Amorette Housh Nurse Practitioner 4545 E Chandler Blvd., Phoenix, AZ 85048 2007-05-07
Find all providers in zip 85048

Competitor

Search similar providers

City PHOENIX
Zip Code 85048

Improve Information

Please comment or provide details below to improve the information on Andrew Poulos.

Dataset Information

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.