NPIMap

Organization Active NPI

Mesa Family Physicians, PLC

  • Family Medicine Physician
  • Mesa, AZ
National Provider Identifier
1174723274
Registry record updated Feb 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
10054 Issued in AZ
Legal business name
MESA FAMILY PHYSICIANS, PLC
Practice address
1425 S Greenfield Rd Ste 101
Mesa, AZ 85206-5505
Phone
(480) 964-5800
Fax
(480) 644-1372
NPI assigned
Jul 18, 2007
Last updated
Feb 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2023

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

Authorized official

Name
Dr. David E. Benton II, M.D.NPI 1952319865
Title
Partner
Phone
(480) 964-5800

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 10054 AZ Primary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 14219 AZ
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 13293 AZ

Addresses

Primary practice location

1425 S Greenfield Rd Ste 101
Mesa, AZ 85206-5505

Mailing address

1425 S Greenfield Rd Ste 101
Mesa, AZ 85206-5505
Phone (480) 964-5800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040623001166 AZ Part B Supplier - Clinic/Group Practice 1456336320 Receives reassigned benefits from 10 practitioners
Practice locations: Mesa, 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
03D0682242Mesa Family Physicians PLC1425 S Greenfield Rd Ste 101, Mesa, AZ 85206Provider-performed microscopyAug 31, 2026

National Provider Directory

National Provider Directory

Locations

1440 S Country Club Dr
Ste 30
Mesa, AZ 85210
Phone (480) 505-0500

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676332800000",
    "number": "1174723274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 S GREENFIELD RD STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852065505",
            "telephone_number": "480-964-5800",
            "fax_number": "480-632-5923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 S GREENFIELD RD STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852065505",
            "telephone_number": "480-964-5800",
            "fax_number": "480-644-1372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESA FAMILY PHYSICIANS, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-18",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A",
        "authorized_official_last_name": "BENTON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "480-964-5800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "10054",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "14219",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "13293",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; 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.