MARVIN JIM
NPI 1841900529
Psychologist in Phoenix, AZ

Active since December 02, 2022PECOS Enrolled
11221 N 28TH DR BLDG E, PHOENIX, AZ 85029(602) 997-2233 Get Directions Write a Review

NPPES record last updated: December 2, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Marvin Jim NPPES

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

MARVIN JIM (NPI 1841900529) is an individual psychologist in Phoenix, Arizona and active in the NPI registry since December 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1841900529
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameMARVIN JIM
Location Address11221 N 28TH DR BLDG EPhoenix, AZ 85029-5615
Mailing Address11221 N 28th Dr Bldg EPhoenix, AZ 85029-5615 · (602) 997-2223
Sole ProprietorYes
Enumeration DateDecember 2, 2022
NPPES CertifiedDecember 2, 2022
✔ NPI 1841900529 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
11221 N 28TH DR BLDG E, Phoenix, AZ 85029

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Marvin Jim is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Marvin Jim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mental Health (Including Community Mental Health Center)
11221 N 28TH DR BLDG E
Phoenix, AZ 85029
  • Reassigned Medicare billing, Arizona enrollment
  • 137 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 14

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

Counselor (Professional)
11221 N 28TH DR BLDG E
PHOENIX, AZ 85029
Student in an Organized Health Care Education/Training Program
11221 N 28TH DR BLDG E
PHOENIX, AZ 85029
Clinic/Center (Mental Health (Including Community Mental Health Center))
11221 N 28TH DR BLDG E
PHOENIX, AZ 85029
Counselor (Mental Health)
11221 N 28TH DR BLDG E
PHOENIX, AZ 85029
Psychiatry & Neurology (Psychiatry)
11221 N 28TH DR BLDG E
PHOENIX, AZ 85029
Counselor (Professional)
11221 N 28TH DR BLDG E
PHOENIX, AZ 85029
Behavior Analyst
11221 N 28TH DR BLDG E
PHOENIX, AZ 85029
Psychologist (Clinical)
11221 N 28TH DR BLDG E
PHOENIX, AZ 85029

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Marvin Jim's NPI number?

The NPI number for Marvin Jim is 1841900529. It was assigned to this individual provider in the NPPES registry on December 2, 2022.

Where is Marvin Jim located?

Marvin Jim practices at 11221 N 28th Dr Bldg E, Phoenix, AZ 85029. The listed phone number is (602) 997-2233.

What is Marvin Jim's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Marvin Jim enrolled in Medicare?

Yes. Marvin Jim is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Marvin Jim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Marvin Jim reassigns Medicare benefits to Southwest Behavioral Health Services (Phoenix, AZ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Marvin Jim's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Marvin Jim accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona and Cigna HealthCare of Arizona, Inc list Marvin Jim as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Marvin Jim was last updated on December 2, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.