Banner -- University Primary Care Physicians LLC
Organization Active NPI Primary Care Clinic/Center · Payson, AZ
NPI 1154791960 · NPPES record last updated Apr 13, 2026
Key facts
- NPI
- 1154791960
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- Legal business name
- BANNER -- UNIVERSITY PRIMARY CARE PHYSICIANS LLC
- Practice address
- 807 S Ponderosa St
Payson, AZ 85541-5542 - Phone
- (928) 471-3222
- NPI assigned
- Oct 6, 2015
- Organization subpart
- Yes
- Parent organization (as reported)
- BANNER UNIVERSITY MEDICAL GROUP
Authorized official
- Name
- Benjamin Schwartz
- Title
- Ceo
- Phone
- (602) 747-4000
Member of 2
Practitioners 86
-
Heather M Bartz, DO
-
Rishi Basnyat, MD
-
Stephanie Briney, DO
-
Steven R Brown, M.D.
-
Jenna Buchanan, MD
-
Bethany Eiseler, MD
-
Kiana Espinosa, MD
-
Scott David Haferkamp, M.D.
-
Nadia Hollowed, MD
-
Harvey Hsu, M.D.
-
Kam D. Hunter, M.D. PH.D.
-
Diem-Thuy Kahlon, D.O.
-
Viktoria Krajnc, MD
-
Nadia Mohammed, MD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 03D0944984 | Banner - University Primary Care Physicians LLC | Provider-performed microscopy | Apr 22, 2028 |
| 03D0957416 | Banner - University Primary Care Physicians LLC | Certificate of waiver | Oct 8, 2026 |
| 03D2303550 | Banner - University Primary Care Physicians LLC | Provider-performed microscopy | Apr 25, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160210001728 | AZ | Part B Supplier - Clinic/Group Practice | 2365746450 |
Receives reassigned benefits from 63 practitioners Practice locations: Phoenix, AZ; Payson, AZ |
National Provider Directory
- Part of
- Alison T Stopeck MD
Locations
10204 W Happy Valley Pkwy
Ste 160
Peoria, AZ 85383
Phone (623) 254-7111
1300 N 12th St
Ste 605608
Phoenix, AZ 85006
Phone (602) 839-4567
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | |||
| Primary Care Clinic/Center | 261QP2300X | Yes |
Addresses
Primary practice location
807 S Ponderosa St
Payson, AZ 85541-5542
Mailing address
2901 N Central Ave Ste 160
Phoenix, AZ 85012-2702
Phone (602) 747-4000
Other practice location 1
1300 N 12th St Ste 500
Phoenix, AZ 85006-2849
Phone (602) 839-4567
Other practice location 2
1300 N 12th St Ste 605&608
Phoenix, AZ 85006-2848
Phone (602) 839-4567
Other practice location 3
1300 N 12th St Ste 508
Phoenix, AZ 85006-2849
Phone (602) 839-3927
Other practice location 4
4200 E Camelback Rd Ste 202
Phoenix, AZ 85018-2718
Phone (602) 229-2200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 086588 | Medicaid | AZ |
Other providers in Payson, AZ
- Rachel Denise Armstrong
- Assisted Living Concepts Inc
- Melissa Marie Avery
- Jessica L Balcom
- Matthew Balls
- Banner Cancer Center Specialists LLC
- Banner Good Samaritan Liver Disease Center
- Banner Health
- Banner Health
- Banner Health
All providers in Payson, AZ · Primary Care 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 13, 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.