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NPI Code Detail

MEDICARE: SMI IMAGING LLC

MEDICARE: SMI IMAGING LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician

General Provider Information

NPI Number : 1548110869
Entity Type Code : Organization
Provider Name (Legal Business Name) : SMI IMAGING LLC
Provider Business Mailing Address
First Line : 16220 N SCOTTSDALE RD STE 600
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85254-1804
Country : US
Telephone Number : 480-306-6949
Fax Number : 602-302-5706
Provider Business Practice Location Address
First Line : 4880 WYNN RD STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-5406
Country : US
Telephone Number : 702-821-4380
Fax Number : 702-821-4381
Authorized Official
Title or Position : CEO
Name : HOWARD JOHN SIMON
Credential : MD
Telephone Number : 480-478-6545
Provider Enumeration Date : 01/28/2026
Last Update Date : 01/28/2026

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Directions to “SMI IMAGING LLC ” Practice Location

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