ELLSWORTH MEDICAL GROUP LLC
NPI 1467928804
General Practice in Queen Creek, AZ

Q: What is Ellsworth Medical Group LLC's NPI number?

The NPI number for Ellsworth Medical Group LLC is 1467928804. It was assigned to this organization in the NPPES registry on October 23, 2018.

Q: What is Ellsworth Medical Group LLC's specialty?

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

Active since October 23, 2018

21323 S ELLSWORTH LOOP RD STE 101, QUEEN CREEK, AZ 85142(480) 307-8440 Get Directions Write a Review

NPPES record last updated: April 23, 2025. 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 2018).

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About Ellsworth Medical Group Llc NPPES

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

ELLSWORTH MEDICAL GROUP LLC (NPI 1467928804) is a healthcare organization registered as a general practice in Queen Creek, Arizona and active in the NPI registry since October 2018. The organization lists Radman Rahiminejad, Owner, as its authorized official.

NPPES Registry Identity

NPI1467928804

Entity TypeOrganization

Primary Taxonomy208D00000X

Legal Business NameELLSWORTH MEDICAL GROUP LLC

Location Address21323 S ELLSWORTH LOOP RD STE 101Queen Creek, AZ 85142-9865

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

Phone(480) 307-8440

Organization SubpartNo

Authorized OfficialRadman RahiminejadOwner · (480) 926-7800

Enumeration DateOctober 23, 2018

Last NPPES UpdateApril 23, 20256 updates tracked since enumeration

NPPES CertifiedApril 23, 2025

✔ NPI 1467928804 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

21323 S ELLSWORTH LOOP RD STE 101, Queen Creek, AZ 85142

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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

Medical Equipment Supplier Medicare DMEPOS 3

Medicare supplier enrollment and the product categories Ellsworth Medical Group LLC carries, from the Medicare DMEPOS supplier directory.

Ellsworth Medical Group LLC

DMEPOS supplier · Queen Creek, AZ

✔

Accepts Medicare assignment

Ellsworth Medical Group LLC agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20452031

Medicare Participant SinceNovember 2, 2018

Supplier Location21323 S Ellsworth Loop Rd Ste 101Queen Creek, AZ 85142

Phone(480) 307-8440

Supplier Specialties

Medical Supply Company Other

Medicare Product Categories

Orthoses: Custom Fabricated

Custom met pads, Custom heel pads, Custom heel spur pads

Orthoses: Prefabricated (Non-Custom Fabricated)

Met pads, Heel pads, Heel spur pads

Orthoses: Off-The-Shelf

Met pads, Heel pads, Heel spur pads

Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 8

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

RITTENHOUSE MEDICAL GROUP, LLC

General Practice