Agh Mesa LLC
Organization Active NPI Emergency Care Clinic/Center · Chandler, AZ
NPI 1164050316 · NPPES record last updated Mar 31, 2020
Key facts
- NPI
- 1164050316
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Care Clinic/Center 261QE0002X
- Legal business name
- AGH MESA LLC
- Practice address
- 1064 E Ray Rd
Chandler, AZ 85225-1542 - Phone
- (480) 494-5100
- NPI assigned
- Mar 31, 2020
- Organization subpart
- No
Authorized official
- Name
- Jane E. Hanson
- Title
- President/Ceo
- Phone
- (480) 410-4523
Owners & managing parties with NPI records 10
Other NPIs on the same Medicare enrollment 8
Corporate family (same tax ID) 8
Affiliated clinicians 246
-
Ryan Patrick Adkins, D.O.
-
Nisar Ahmed, MD
-
Hossam Alhabach, M.D.
-
Rafah Salih Alsahlani, D.O.
-
Haneen Alwawi, CRNA
-
Lina Anthony, MD
-
Estela Apolinar, M.D.
-
Robert Bobek Arashahi, M.D.
-
Hammad Ashraf, DO
-
Parham Ayazi, MD
-
Scott Babb, MD
-
Shiv Bagga, MD
-
Faisal A Bahadur, M.D.
-
Jed M Bayasi, MD
-
Marshall Barr Bergen, CRNA
-
Andrew Bergeson, DO
-
Jon Bingham, CRNA
-
Nathan E Bodily, M.D.
-
David E. Boesch, M.D.
-
Jordan Bohrer, CRNA
-
Anne Borik, DO
Medicare Care Compare: Hospital
- Listed as
- Dignity Health Arizona General Hospital
- Overall star rating
- ★★★★★ 5 of 5
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in 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
- LLC · Non-profit
- Incorporated
- Jan 22, 2016 in AZ
- Enrollment address
- 9130 E Elliot Rd
Mesa, AZ 85212-9675 - Hospital subgroups
- General, Acute care
All disclosed owners & managing parties 13
| Name | Role | Since | Share |
|---|---|---|---|
| Agh Phoenix LLC |
5% Or Greater Direct Ownership Interest | Jan 22, 2016 | 100% |
| Eric T Sorensen |
Corporate Director |
Nov 1, 2022 | |
| Jeffrey Thomas O'Malley |
Corporate Director |
Mar 1, 2020 | |
| Commonspirit Health |
5% Or Greater Indirect Ownership Interest | Feb 1, 2019 | 100% |
| Operational/Managerial Control | Feb 1, 2019 | ||
| Dignity Health |
Other | Feb 1, 2019 | |
| Cynthia Rosenberg |
Corporate Officer |
Nov 11, 2022 | |
| Corporate Director |
Nov 11, 2022 | ||
| Peggy Sanborn |
Corporate Director |
Aug 22, 2019 | |
| Daniel Morissette |
Corporate Officer |
Feb 1, 2019 | |
| Other |
Sep 1, 2023 | ||
| Derek Havens |
Corporate Director |
May 1, 2022 | |
| Larissa Spraker |
Corporate Officer |
Nov 1, 2021 | |
| Corporate Director |
Nov 1, 2022 | ||
| John Bauer |
Corporate Officer |
Nov 4, 2019 | |
| Operational/Managerial Control |
Nov 4, 2019 | ||
| Dignity Community Care |
5% Or Greater Indirect Ownership Interest | Feb 1, 2019 | 100% |
| Bradley Pristelski |
Corporate Director |
Mar 1, 2020 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- Agh Mesa LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Care Clinic/Center | 261QE0002X | Yes |
Addresses
Primary practice location
1064 E Ray Rd
Chandler, AZ 85225-1542
Mailing address
3030 N Central Ave Ste 1402
Phoenix, AZ 85012-2720
Phone (602) 406-3306
Other names
- DIGNITY HEALTH ARIZONA GENERAL HOSPITAL EMERGENCY ROOM - CHANDLER MCQU
Other providers in Chandler, AZ
- Agave Family Dental PLLC
- Agave Matrix LLC
- Agh Laveen LLC
- Agh Laveen LLC
- Agh Mesa LLC
- Shireen A Aghdami
- Courtney Agliano
- Kush Agrawal
- Yashwant Agrawal
- Clarrissa Aguila
All providers in Chandler, AZ · Emergency 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 Mar 31, 2020. 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.
- 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.