MIRAGE MEDICAL LLC
NPI 1609206549
Physical Medicine & Rehabilitation - Pain Medicine in Phoenix, AZ

Q: What is the provider's specialty?

The provider's specialty is Physical Medicine & Rehabilitation with taxonomy code 2081P2900X and a focus in Pain Medicine.

Active since November 13, 2013

10046 N METRO PKWY W, SUITE 115, PHOENIX, AZ 85051(602) 674-5515(602) 674-3029 Get Directions Write a Review

NPPES record last updated: November 13, 2013. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Mirage Medical Llc NPPES

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

MIRAGE MEDICAL LLC (NPI 1609206549) is a healthcare organization registered as a pain medicine in Phoenix, Arizona and active in the NPI registry since November 2013. The organization lists Jeremy R Buckner, Owner, as its authorized official.

NPPES Registry Identity

NPI1609206549

Entity TypeOrganization

Primary Taxonomy2081P2900X

Legal Business NameMIRAGE MEDICAL LLC

Location Address10046 N METRO PKWY W, SUITE 115Phoenix, AZ 85051-1437

Mailing Address1001 E Warner Rd, Suite 107Tempe, AZ 85284-3224 · (480) 264-3744 · Fax (480) 264-2075

Phone(602) 674-5515

Fax(602) 674-3029

Organization SubpartNo

Authorized OfficialJeremy R BucknerOwner · (602) 421-2730

Enumeration DateNovember 13, 2013

✔ NPI 1609206549 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPhysical Medicine & Rehabilitation · Pain MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2081P2900X

License✔ Licensed in AZ · 5988

Definition

A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists.

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License AP4986 (AZ)

Also ListedClinical Nurse Specialist · Family HealthTaxonomy 364SF0001X · License AP2828 (AZ)

10046 N METRO PKWY W, Phoenix, AZ 85051

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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