Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mirage Medical LLC

Organization Pain Medicine (Physical Medicine & Rehabilitation) Physician · NPI 1609206549

Mirage Medical LLC is a Pain Medicine (Physical Medicine & Rehabilitation) Physician in Phoenix, Arizona. Licensed in Arizona. Registered with an NPI since 2013.

Licensed in
AZ
In the registry since
2013
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

10046 N Metro Pkwy W Ste 115
Phoenix, AZ 85051-1437
Phone: (602) 674-5515
Fax: (602) 674-3029
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pain Medicine (Physical Medicine & Rehabilitation) Physician (primary) Taxonomy 2081P2900X · Licence 5988 (AZ)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence AP4986 (AZ)
Family Health Clinical Nurse Specialist Taxonomy 364SF0001X · Licence AP2828 (AZ)

Record details

NPI number1609206549
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeremy Buckner — Owner · (602) 421-2730
NPI enumeratedNovember 13, 2013
Last updated in NPPESNovember 13, 2013
Mailing address1001 E Warner Rd, Suite 107, Tempe, AZ 85284-3224

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