Organization Active NPI

Banner -- University Primary Care Physicians LLC

  • Primary Care Clinic/Center
  • Payson, AZ
National Provider Identifier
1154791960
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 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
Last updated
Apr 13, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
BANNER UNIVERSITY MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Authorized official

Name
Benjamin SchwartzNPI 1235164120
Title
Ceo
Phone
(602) 747-4000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X
Primary Care Clinic/Center 261QP2300X Primary

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

4200 E Camelback Rd Ste 202
Phoenix, AZ 85018-2718
Phone (602) 229-2200

Other practice location 2

1300 N 12th St Ste 500
Phoenix, AZ 85006-2849
Phone (602) 839-4567

Other practice location 3

1300 N 12th St Ste 605&608
Phoenix, AZ 85006-2848
Phone (602) 839-4567

Other practice location 4

1300 N 12th St Ste 508
Phoenix, AZ 85006-2849
Phone (602) 839-3927

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160210001728 AZ Part B Supplier - Clinic/Group Practice 2365746450 Receives reassigned benefits from 63 practitioners
Practice locations: Phoenix, AZ; Payson, AZ

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
03D0944984Banner - University Primary Care Physicians LLC1300 N 12TH St Ste 605, Phoenix, AZ 85006Provider-performed microscopyApr 22, 2028
03D0957416Banner - University Primary Care Physicians LLC1300 N 12TH St Ste 508, Phoenix, AZ 85006Certificate of waiverOct 8, 2026
03D2303550Banner - University Primary Care Physicians LLC1300 N 12TH St Ste 500, Phoenix, AZ 85006Provider-performed microscopyApr 25, 2028

National Provider Directory

National Provider Directory
Part of
Universtiy Phys

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

8510 W Deer Valley Rd
Ste C2
Peoria, AZ 85382

37100 N Gantzel Rd
Ste 201
San Tan Vly, AZ 85140
Phone (480) 394-4469

Practitioners & affiliated clinicians

Practitioners 84

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 84

NPI Registry JSON

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

{
    "created_epoch": "1444089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776038400000",
    "number": "1154791960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 N CENTRAL AVE STE 160",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122702",
            "telephone_number": "602-747-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 S PONDEROSA ST",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855415542",
            "telephone_number": "928-471-3222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4200 E Camelback Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850182718",
            "country_code": "US",
            "telephone_number": "602-229-2200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1300 N 12th St Ste 500",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850062849",
            "country_code": "US",
            "telephone_number": "602-839-4567",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1300 N 12th St Ste 605&608",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850062848",
            "country_code": "US",
            "telephone_number": "602-839-4567",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1300 N 12th St Ste 508",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850062849",
            "country_code": "US",
            "telephone_number": "602-839-3927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BANNER -- UNIVERSITY PRIMARY CARE PHYSICIANS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BANNER UNIVERSITY MEDICAL GROUP",
        "enumeration_date": "2015-10-06",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A",
        "authorized_official_last_name": "SCHWARTZ",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-747-4000"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Payson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.