Individual provider Active NPI

Mark Chorebanian, MD

  • Internal Medicine Physician
  • Lake Havasu City, AZ
National Provider Identifier
1003860842
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20398 Issued in AZ
Practice address
101 Civic Center LN
Lake Havasu City, AZ 86403-5607
Phone
(928) 453-0174
NPI assigned
May 19, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 20398 AZ
Internal Medicine Physician 207R00000X 20398 AZ Primary

Addresses

Primary practice location

101 Civic Center LN
Lake Havasu City, AZ 86403-5607

Mailing address

3337 N Forgeus Ave
Tucson, AZ 85716-1165
Phone (520) 240-8254

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040615000024 AZ Practitioner - Internal MedicinePractitioner - Emergency Medicine 2769466150 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Emergency Medicine
Education
R Franklin University of Med & Sci/Chicago Medical School, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3402 E Broadway Blvd
Tucson, AZ 85716-5406
Phone (520) 318-5515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20398AZMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
El Con Health & Wellness Center LLC CurrentSince Nov 2, 2019 Accepting new patients
Navajo Health Foundation-Sage Memorial Hospital, Inc. CurrentSince Oct 4, 2024 Accepting new patients
Navajo Health Foundation-Sage Memorial Hospital Inc CurrentSince Oct 4, 2024 Accepting new patients
Green Valley Emergency Physicians, LLC Emergency Medicine CurrentSince Dec 1, 2021 Accepting new patients
Saddle Gap Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Chase Dennis Emergency Medical Group Inc Emergency Medicine Past Accepting new patients
Az Corridor Emergency Physicians Emergency Medicine Past Accepting new patients
Pinnacle Medicine Inc. Past Accepting new patients
University Physicians Healthcare Past Accepting new patients
Grand Canyon State Inpatient Services Past Accepting new patients
London Bridge Emergency Physicians Emergency Medicine Past Accepting new patients

Locations

4455 S I 19 Frontage Rd
Green Valley, AZ 85614
Phone (520) 393-4700

3402 E Broadway Blvd
Tucson, AZ 85716
Phone (480) 498-8948

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19231/brand/1/csg/1/fhir/r4

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1003860842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3337 N FORGEUS AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857161165",
            "telephone_number": "520-240-8254",
            "fax_number": "520-323-5957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CIVIC CENTER LN",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035607",
            "telephone_number": "928-453-0174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOREBANIAN",
        "first_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "20398",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "20398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

Verify at the official NPI Registry.