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ANDREW POULOS MD
NPI 1912977992
Radiology - Diagnostic Radiology in Phoenix, AZ

Active since January 24, 2006PECOS Enrolled
75/100
CMS Quality Rating
15810 S 45TH ST STE 110, PHOENIX, AZ 85048(480) 763-7273 Get Directions Write a Review

NPPES record last updated: August 28, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Andrew Poulos Md NPPES

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

ANDREW POULOS MD (NPI 1912977992) is an individual diagnostic radiology provider in Phoenix, Arizona, licensed in Arizona (15512) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1912977992
Entity TypeIndividualMale
Primary Taxonomy2085R0202X
Provider Legal NameANDREW POULOSCredential: MD
Location Address15810 S 45TH ST STE 110Phoenix, AZ 85048-7695
Mailing Address7416 E Palo Verde DrScottsdale, AZ 85250-6030 · (480) 888-6248
Phone(480) 763-7273
Sole ProprietorNo
Enumeration DateJanuary 24, 2006
Last NPPES UpdateAugust 28, 2019
✔ NPI 1912977992 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
License✔ Licensed in AZ · 15512
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
15810 S 45TH ST STE 110, Phoenix, AZ 85048
Open in Google Maps ↗

Other Identifiers 1

Medicaid171281AZ

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Andrew Poulos Md 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 Andrew Poulos reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Smi Imaging LLC
3.4 mi
Radiology, Mobile Mammography
8380 S KYRENE RD STE 105
Tempe, AZ 85284
  • Reassigned Medicare billing, Arizona enrollment
  • 178 clinicians in this Medicare group
NPI 1609412642 (480) 961-5760

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85048 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.89 typical visit price
range $55.44 – $168.60
Typical copayment $21.47 (range $13.86 – $42.15)
Most-billed visit code 99203
Established Patient
$69.24 typical visit price
range $17.72 – $137.41
Typical copayment $17.31 (range $4.43 – $34.35)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored

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 Andrew Poulos's NPI number?

The NPI number for Andrew Poulos is 1912977992. It was assigned to this individual provider in the NPPES registry on January 24, 2006.

Where is Andrew Poulos located?

Andrew Poulos practices at 15810 S 45th St Ste 110, Phoenix, AZ 85048. The listed phone number is (480) 763-7273.

What is Andrew Poulos's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Is Andrew Poulos enrolled in Medicare?

Yes. Andrew Poulos is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Andrew Poulos's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Andrew Poulos reassigns Medicare benefits to Smi Imaging LLC (Tempe, 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 Andrew Poulos's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Andrew Poulos was last updated on August 28, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.