NPIMap

Organization Active NPI

Honorhealth Medical Group, LLC

Doing business as Del Lago Family Medicine

  • Family Medicine Physician
  • Peoria, AZ
National Provider Identifier
1285933820
Registry record updated Oct 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HONORHEALTH MEDICAL GROUP, LLC
Doing business as
Del Lago Family Medicine
John C. Lincoln, LLC
Practice address
20470 N Lake Pleasant Rd
Ste. 110
Peoria, AZ 85382-9708
Phone
(623) 266-4699
Fax
(623) 825-5630
NPI assigned
Mar 22, 2011
Last updated
Oct 2, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2020

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

Authorized official

Name
Savas Petrides
Title
SVP/Ceo
Phone
(480) 696-4020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

20470 N Lake Pleasant Rd
Ste. 110
Peoria, AZ 85382-9708

Mailing address

2500 W Utopia Rd
Phoenix, AZ 85027-4171
Phone (480) 587-5314

Other names 2

  • Del Lago Family Medicine Doing business as
  • John C. Lincoln, LLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031119000717 AZ Part B Supplier - Clinic/Group Practice 1557274057 Receives reassigned benefits from 518 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Pinnacle Radiology66 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

10550 E Desert Hills Dr
Scottsdale, AZ 85262
Phone (480) 265-2140

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1300752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601596800000",
    "number": "1285933820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W UTOPIA RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274171",
            "telephone_number": "480-587-5314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20470 N LAKE PLEASANT RD",
            "address_2": "STE. 110",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853829708",
            "telephone_number": "623-266-4699",
            "fax_number": "623-825-5630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HONORHEALTH MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-22",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A",
        "authorized_official_last_name": "PETRIDES",
        "authorized_official_first_name": "SAVAS",
        "authorized_official_title_or_position": "SVP/CEO",
        "authorized_official_telephone_number": "480-696-4020"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Del Lago Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "John C. Lincoln, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.