NPIMap

Organization Active NPI

Agh Mesa LLC

  • Emergency Care Clinic/Center
  • Chandler, AZ
National Provider Identifier
1124656376
Registry record updated Mar 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Care Clinic/CenterTaxonomy code 261QE0002X
Legal business name
AGH MESA LLC
Practice address
2977 E Germann Rd
Chandler, AZ 85286-1586
Phone
(480) 732-7540
NPI assigned
Mar 31, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2020

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

Authorized official

Name
Jane E. Hanson
Title
President/Ceo
Phone
(480) 410-4523

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Care Clinic/Center 261QE0002X Primary

Addresses

Primary practice location

2977 E Germann Rd
Chandler, AZ 85286-1586

Mailing address

3030 N Central Ave Ste 1402
Phoenix, AZ 85012-2720
Phone (602) 406-3306

Other names 1

  • DIGNITY HEALTH ARIZONA GENERAL HOSPITAL EMERGENCY ROOM - CHANDLER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170130001275 AZ Part A Provider - Hospital 1153603022 8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chandler, AZ; Gilbert, AZ; Mesa, AZ; Phoenix, AZ; San Tan Valley, AZ; Tempe, AZ

Hospital certification: CCN 030139

Legal name
AGH MESA LLC
Doing business as
DIGNITY HEALTH ARIZONA GENERAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jan 15, 2019
Last certification
Jan 15, 2019
Beds
50
Ownership / control type
Private (not for profit)
Organization structure
LLCNon-profit
Incorporated
Jan 22, 2016 in AZ
Enrollment address
9130 E Elliot Rd
Mesa, AZ 85212-9675
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Other NPIs on the same Medicare enrollment 8

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Dignity Health Arizona General HospitalCCN 030139
Overall star rating
5 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2092228Dignity Health Arizona General Hospital-Chandler2977 E Germann Rd, Chandler, AZ 85286AccreditationMar 22, 2028

National Provider Directory

National Provider Directory
Tax ID family
Agh Mesa LLC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1064 E Ray Rd
Chandler, AZ 85225
Phone (480) 494-5100

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
Agh Phoenix LLC Organization, Phoenix, AZ LLC 5% Or Greater Direct Ownership Interest Jan 22, 2016 100%
Eric T Sorensen Individual Corporate DirectorBoard Member Nov 1, 2022
Jeffrey Thomas O'Malley Individual Corporate DirectorBod Member Mar 1, 2020
Commonspirit Health Organization, Chicago, IL Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Feb 1, 2019 100%
Operational/Managerial Control Feb 1, 2019
Dignity Health Organization, San Francisco, CA Corporation, Non-profit Other Feb 1, 2019
Cynthia Rosenberg Individual Corporate OfficerCeo Nov 11, 2022
Corporate DirectorCeo Nov 11, 2022
Peggy Sanborn Individual Corporate DirectorBod Member Aug 22, 2019
Daniel Morissette Individual Corporate OfficerCfo, Home Office Administrator Feb 1, 2019
OtherCfo, Home Office Administrator Sep 1, 2023
Derek Havens Individual Corporate DirectorBoard Member May 1, 2022
Larissa Spraker Individual Corporate OfficerChairman Nov 1, 2021
Corporate DirectorBoard Member Nov 1, 2022
John Bauer Individual Corporate OfficerCfo Nov 4, 2019
Operational/Managerial ControlCfo Nov 4, 2019
Dignity Community Care Organization, San Francisco, CA Created for acquisition, Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Feb 1, 2019 100%
Bradley Pristelski Individual Corporate DirectorBod Member Mar 1, 2020

Owners & managing parties with NPI records 10

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

Practitioners & affiliated clinicians

Affiliated clinicians 246

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

View all 246

NPI Registry JSON

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585612800000",
    "number": "1124656376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 N CENTRAL AVE STE 1402",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122720",
            "telephone_number": "602-406-3306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2977 E GERMANN RD",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852861586",
            "telephone_number": "480-732-7540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGH MESA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-31",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A",
        "authorized_official_last_name": "HANSON",
        "authorized_official_first_name": "JANE",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "480-410-4523"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DIGNITY HEALTH ARIZONA GENERAL HOSPITAL EMERGENCY ROOM - CHANDLER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.