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

Southwest Physiatry PLLC

Organization Sports Medicine (Physical Medicine & Rehabilitation) Physician · NPI 1407367139

Southwest Physiatry PLLC is a Sports Medicine (Physical Medicine & Rehabilitation) Physician in Phoenix, Arizona. Registered with an NPI since 2017.

In the registry since
2017
Specialties on file
2
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4550 E Bell Rd Ste 152
Phoenix, AZ 85032-9382
Phone: (617) 538-3650
Fax: (888) 384-2827
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Physical Medicine & Rehabilitation) Physician (primary) Taxonomy 2081S0010X · Licence 44220
Prosthetic/Orthotic Supplier Taxonomy 335E00000X

Record details

NPI number1407367139
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Crincoli — President · (617) 538-3650
NPI enumeratedOctober 20, 2017
Last updated in NPPESJuly 22, 2026
Certification dateJuly 22, 2026
Mailing address10243 N 24th St, Phoenix, AZ 85028-3606

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