NPIMap

Organization Active NPI

La Paz Regional Hospital Inc

  • Critical Access Hospital
  • Parker, AZ
National Provider Identifier
1053684555
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
LA PAZ REGIONAL HOSPITAL INC
Practice address
1200 W Mohave Rd
Parker, AZ 85344-6349
Phone
(928) 669-9201
Fax
(928) 669-7409
NPI assigned
Feb 14, 2012
Last updated
Nov 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Authorized official

Name
Zafer Genc
Title
Ceo
Phone
(928) 669-7300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Primary

Addresses

Primary practice location

1200 W Mohave Rd
Parker, AZ 85344-6349

Mailing address

1200 W Mohave Rd
Parker, AZ 85344-6349
Phone (928) 669-9201

Other identifiers 2

IdentifierTypeStateIssuer
7470600001OtherAZDME PTAN
480046MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20031219000694 AZ Part B Supplier - Clinic/Group Practice 1557273356 Receives reassigned benefits from 94 practitioners
10 other NPIs on this enrollment
Practice locations: Salome, AZ; Quartzsite, AZ; Parker, AZ; Bouse, AZ
O20120409000056 AZ Part A Provider - Critical Access Hospital 1557273356 Receives reassigned benefits from 68 practitioners
1 other NPI on this enrollment
Practice locations: Parker, AZ
O20160215000843 AZ DME Supplier - Physician - Podiatry 1557273356 Practice locations: Parker, AZ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053684555. Details of each certification follow.

Hospital certification: CCN 031317

Legal name
LA PAZ REGIONAL HOSPITAL INC
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Oct 24, 2013
Last certification
Oct 24, 2013
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jun 1, 2000 in AZ
Enrollment address
1200 W Mohave Rd
Parker, AZ 85344-6349

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
La Paz Regional HospitalCCN 031317 · All quality measures
Overall star rating
2 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: abedonsaiz@lprh.medalliesdirect.net
  • Direct secure messaging: adamberkovits@lprh.medalliesdirect.net
  • Direct secure messaging: adamcaton@lprh.medalliesdirect.net
  • Direct secure messaging: afrozeahmad@lprh.medalliesdirect.net
  • Direct secure messaging: amandaburshia@lprh.medalliesdirect.net
  • Direct secure messaging: amandalal@lprh.medalliesdirect.net
  • Direct secure messaging: angelabraaten@lprh.medalliesdirect.net
  • Direct secure messaging: angelawalther@lprh.medalliesdirect.net
  • Direct secure messaging: anndejong@lprh.medalliesdirect.net
  • Direct secure messaging: bartonbutterbaugh@lprh.medalliesdirect.net
  • Direct secure messaging: brettgochnour@lprh.medalliesdirect.net
  • Direct secure messaging: brianpeters@lprh.medalliesdirect.net
  • Direct secure messaging: deniseroemen-kramer@lprh.medalliesdirect.net
  • Direct secure messaging: denniscrawford@lprh.medalliesdirect.net
  • Direct secure messaging: devincunning@lprh.medalliesdirect.net
  • Direct secure messaging: donaldwalpole@lprh.medalliesdirect.net
  • Direct secure messaging: elishabremmer@lprh.medalliesdirect.net
  • Direct secure messaging: fadiatassi@lprh.medalliesdirect.net
  • Direct secure messaging: fayzyarkhan@lprh.medalliesdirect.net
  • Direct secure messaging: frederickjohnson@lprh.medalliesdirect.net

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Keith W Shillito Individual Corporate DirectorBoard Member Oct 1, 2012
La Paz Regional Hospital Inc Organization, Parker, AZ Non-profit Operational/Managerial Control Jan 1, 2017 100%
Lin Bachtel Individual Corporate Director Sep 1, 2018
Mary Hamilton Individual Corporate Director Oct 1, 2016
Cory Madoneczky Individual Corporate Director Feb 1, 2023
Norman Simpson Individual Corporate Director Sep 1, 2012
Robert Page Individual Corporate Director Feb 1, 2017
Julian Barbara Individual Corporate DirectorBoard Member Oct 1, 2012
Zafer Genc Individual Corporate OfficerChief Executive Officer Jan 1, 2022
W-2 Managing EmployeeChief Executive Officer Jan 1, 2022
Operational/Managerial ControlChief Executive Officer Jan 1, 2022
Randy Smith Individual Corporate Director Feb 1, 2023
Cheryl Montijo Individual Corporate Director Oct 1, 2000
Linda M Cushman Individual Corporate Director Jun 1, 2018
Christine a Barrington Individual Corporate Officer Oct 31, 2022
W-2 Managing Employee Oct 31, 2022
Operational/Managerial Control Oct 31, 2022

Owners & managing parties with NPI records 7

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
La Paz Regional Hospital IncParker, AZ, CCN 03Z317 Hospital Operational/Managerial Control Jan 1, 2017
La Paz Medical Services-QuartzsiteQuartzsite, AZ, CCN 033987 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Nov 7, 1994
Tri-Valley Medical CenterSalome, AZ, CCN 033994 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2006
Bouse Medical ClinicBouse, AZ, CCN 033999 Rural health clinic 5% Or Greater Direct Ownership Interest Jan 1, 1990

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 4

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 137

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 137

Affiliated clinicians 155

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 155

NPI Registry JSON

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

{
    "created_epoch": "1329177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730937600000",
    "number": "1053684555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W MOHAVE RD",
            "city": "PARKER",
            "state": "AZ",
            "postal_code": "853446349",
            "telephone_number": "928-669-9201",
            "fax_number": "928-669-7409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W MOHAVE RD",
            "city": "PARKER",
            "state": "AZ",
            "postal_code": "853446349",
            "telephone_number": "928-669-9201",
            "fax_number": "928-669-7409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA PAZ REGIONAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-14",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A",
        "authorized_official_last_name": "GENC",
        "authorized_official_first_name": "ZAFER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "928-669-7300"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME PTAN",
            "identifier": "7470600001",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "480046",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parker, AZ

Sources for this page

Verify at the official NPI Registry.