MEDICARE: SMI IMAGING, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QR0207X	Mobile Mammography Clinic/Center
2	261QM1200X	Magnetic Resonance Imaging (MRI) Clinic/Center
3	2085R0204X	Vascular & Interventional Radiology Physician
4	363LF0000X	Family Nurse Practitioner
5	363L00000X	Nurse Practitioner
6	2085R0202X	Diagnostic Radiology Physician

General Provider Information

NPI Number	:	1972004489
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	:	6740 E CAMELBACK RD STE 100
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85251-2096
Country	:	US
Telephone Number	:	602-651-1945
Fax Number	:	602-302-5706

Authorized Official
Title or Position	:	CEO
Name	:	HOWARD JOHN SIMON
Credential	:	MD
Telephone Number	:	480-478-6545

Provider Enumeration Date	:	02/21/2018
Last Update Date	:	12/12/2025

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