Healthcare Provider Details

I. General information

NPI: 1326360231
Provider Name (Legal Business Name): ORTHOPEDIC SPECIALISTS OF NORTH AMERICA, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2010
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18555 N 79TH AVE STE E101
GLENDALE AZ
85308-8392
US

IV. Provider business mailing address

PO BOX 80271
PHOENIX AZ
85060-0271
US

V. Phone/Fax

Practice location:
  • Phone: 602-631-3161
  • Fax: 602-631-3162
Mailing address:
  • Phone: 602-385-2115
  • Fax: 480-418-3323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: RAJAN DILIP BHATT
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 602-385-2115