28TH STREET MEDICAL GROUP, LLC
NPI 1447723598
General Practice in Phoenix, AZ

Q: What is 28th Street Medical Group, LLC's NPI number?

The NPI number for 28th Street Medical Group, LLC is 1447723598. It was assigned to this organization in the NPPES registry on January 10, 2019.

Q: What is 28th Street Medical Group, LLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Active since January 10, 2019CLIA 03D2055238 · Waiver

2836 E INDIAN SCHOOL RD STE A8, PHOENIX, AZ 85016(602) 840-0056(480) 926-2260 Get Directions Write a Review

NPPES record last updated: January 5, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 5, 2023, Aug 19, 2021, Dec 26, 2019 and 3 more (6 updates tracked since 2019).

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About 28th Street Medical Group, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

28TH STREET MEDICAL GROUP, LLC (NPI 1447723598) is a healthcare organization registered as a general practice in Phoenix, Arizona and active in the NPI registry since January 2019. The organization holds a CLIA Waiver certificate valid through March 6, 2027 and lists Radman Rahiminejad, Owner, as its authorized official.

NPPES Registry Identity

NPI1447723598

Entity TypeOrganization

Primary Taxonomy208D00000X

Legal Business Name28TH STREET MEDICAL GROUP, LLC

Location Address2836 E INDIAN SCHOOL RD STE A8Phoenix, AZ 85016-6864

Mailing AddressPo Box 6610Chandler, AZ 85246-6610 · (480) 926-7800 · Fax (480) 926-2260

Phone(602) 840-0056

Fax(480) 926-2260

Organization SubpartNo

Authorized OfficialRadman RahiminejadOwner · (480) 926-7800

Enumeration DateJanuary 10, 2019

Last NPPES UpdateJanuary 5, 20236 updates tracked since enumeration

NPPES CertifiedJanuary 5, 2023

✔ NPI 1447723598 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Also ListedChiropractorTaxonomy 111N00000X

Also ListedPhysical Medicine & RehabilitationTaxonomy 208100000X

Also ListedPhysical TherapistTaxonomy 225100000X

Also ListedPhysician AssistantTaxonomy 363A00000X

2836 E INDIAN SCHOOL RD STE A8, Phoenix, AZ 85016

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D2055238

28th Street Medical Group LLC · Phoenix, AZ

Active · expires Mar 6, 2027

CLIA Number03D2055238

Laboratory TypePhysician Office

Certificate Effective DateMarch 7, 2025

Certificate Expiration DateMarch 6, 2027

Laboratory DirectorJennifer Fontius

Laboratory Phone(480) 926-7800

Laboratory Location28th Street Medical Group LLC2824 E Indian School Rd #5, Phoenix, AZ 85016

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATHLEEN CALLAHAN PA-C

Physician Assistant