La Paz Regional Hospital, Inc.
Organization Active NPI Rural Health Clinic/Center · Quartzsite, AZ
NPI 1013932938 · NPPES record last updated Apr 27, 2026
Key facts
- NPI
- 1013932938
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- License
- OTC0810 (AZ)
- Legal business name
- LA PAZ REGIONAL HOSPITAL, INC.
- Practice address
- 150 E Tyson Road
Quartzsite, AZ 85359 - Phone
- (928) 927-8747
- Fax
- (928) 927-8748
- NPI assigned
- Jul 12, 2006
- Organization subpart
- No
Authorized official
- Name
- Guadalupe Michelle Baldenegro
- Title
- Medical Staff Coordinator
- Phone
- (928) 669-7382
Owners & managing parties with NPI records 7
-
Keith Westley Shillito, M.D.
Owned or controlled facilities with NPI records 5
Other NPIs on the same Medicare enrollment 10
Other NPIs with the same Medicare PAC ID 6
Related certifications (CCN) 2
Facilities with the same owner 4
Practitioners 55
-
Huma Sarah Qureshi, M.D.
-
David Philip Reiner, M.D.
-
Afroze A Ahmad, MD
-
Tahir Alkhairy, MD
-
Adam Caton, DPM
-
Jack D Dunn, M.D.
-
Elizabeth Ann Fisher, FNP
-
Brett Shane Gochnour, D.O.
-
Mostafa Tawfiq Jabassini, M.D.
-
Daniel Nathan Lucas, M.D.
-
Thomas C Ly, MD
-
Kamiar Massrour, M.D.
-
Silvia McGuire, FNP-C
-
Norman Estrada Mendoza, M.D.
-
Khalid Naqi, MD
-
Stacy Nelson, RN
-
Fayz Yar Khan, M.D.
-
Traci Richards Burks, NURSE PRACTITIONER
-
Lance R Burrell, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AZ
Rural health clinic certification: CCN 033987
- Legal name
- LA PAZ REGIONAL HOSPITAL INC
- Doing business as
- LA PAZ MEDICAL SERVICES-QUARTZSITE
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Feb 13, 2004
- Last certification
- Jun 14, 2022
- Ownership / control type
- 2C
- Organization structure
- Corporation · Non-profit
- Incorporated
- Feb 9, 1972 in AZ
- Enrollment address
- 150 E Tyson Rd
Quartzsite, AZ 85359-4618 - Related CCNs
- 031317
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| Keith W Shillito |
Corporate Director | Apr 1, 2016 | |
| La Paz Regional Hospital Inc |
5% Or Greater Direct Ownership Interest | Nov 7, 1994 | 100% |
| Lin Bachtel |
Corporate Director | Sep 1, 2018 | |
| Mary Hamilton |
Corporate Director | Oct 1, 2016 | |
| Cory Madoneczky |
Corporate Director | Feb 1, 2023 | |
| Norman Simpson |
Corporate Director | Sep 1, 2012 | |
| Robert Page |
Corporate Officer | Feb 1, 2017 | |
| Julian Barbara |
Corporate Director |
Oct 1, 2011 | |
| Zafer Genc |
Corporate Officer | Jan 1, 2022 | |
| W-2 Managing Employee | Jan 1, 2022 | ||
| Randy Smith |
Corporate Director | Feb 1, 2023 | |
| Cheryl Montijo |
Corporate Director |
Oct 1, 2012 | |
| Linda M Cushman |
Corporate Director | Jun 1, 2018 |
All facility ownership & control disclosures 4
| Facility | Type | Role | Since |
|---|---|---|---|
| La Paz Regional Hospital Inc |
Hospital | Operational/Managerial Control (100%) | Jan 1, 2017 |
| La Paz Regional Hospital Inc |
Hospital | Operational/Managerial Control | Jan 1, 2017 |
| Tri-Valley Medical Center |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2006 |
| Bouse Medical Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest | Jan 1, 1990 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031025000001 | AZ | Part a Provider - Rural Health Clinic | 1557273356 | Practice locations: Quartzsite, AZ |
| O20031219000694 | AZ | Part B Supplier - Clinic/Group Practice | 1557273356 |
Receives reassigned benefits from 94 practitioners 10 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Salome, AZ; Quartzsite, AZ; Parker, AZ; Bouse, AZ |
National Provider Directory
Interoperability endpoints
- https://fhir-usa.unify.chbase.com/org/lapaz-b154c12f
- https://api.platform.athenahealth.com/17369/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | OTC0810 | AZ | Yes |
Addresses
Primary practice location
150 E Tyson Road
Quartzsite, AZ 85359
Mailing address
1200 W Mohave Rd
Parker, AZ 85344-6349
Phone (928) 669-9201
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 480046 | Medicaid | AZ | |
| CG7880 | Other | AZ | MEDICARE RR |
Other names
- La Paz Medical Services-Quartzsite
Other providers in Quartzsite, AZ
- Leesa Dian Bolden
- Toni Kay Coleman
- Brett Shane Gochnour
- Happy Valley Pharmacy LLC
- La Paz Regional Hospital Inc
- Lakeside Orthopedic Institute, LLC
- Medi-First Medical Center P.L.L.C.
- Medi-First Medical Center P.L.L.C.
- Opas & Puangtong Jutabha
- Benvinda Ann Pereira
All providers in Quartzsite, AZ · Rural Health Clinic/Center in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 27, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.