Healthcare Provider Details

I. General information

NPI: 1699336313
Provider Name (Legal Business Name): ORTHOPEDIC SPECIALISTS OF NORTH AMERICA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2019
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40601 N GANTZEL RD STE 103
SAN TAN VALLEY AZ
85140-7036
US

IV. Provider business mailing address

PO BOX 80217
PHOENIX AZ
85060-0217
US

V. Phone/Fax

Practice location:
  • Phone: 480-964-2908
  • Fax: 480-833-2136
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 Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

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