Archwell Health Professional Services of Arizona, LLC
Organization Active NPI Internal Medicine Physician · Mesa, AZ
NPI 1558026880 · NPPES record last updated Mar 11, 2026
Key facts
- NPI
- 1558026880
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- ARCHWELL HEALTH PROFESSIONAL SERVICES OF ARIZONA, LLC
- Practice address
- 4315 E Main St
Mesa, AZ 85205-8605 - Phone
- (480) 870-7500
- Fax
- (480) 906-2173
- NPI assigned
- Nov 2, 2021
- Organization subpart
- No
Authorized official
- Name
- Amy Moddesette
- Title
- Sr. Director, Managed Care Ops
- Phone
- (629) 224-1614
Practitioners 121
-
Matthew Bell, DO
-
Carrie Church, NP
-
Ramla Abbas, M.D.
-
Lauren Elaine Maxham, M.D.
-
Praseeda Akella, MD
-
Nneka Feora Anuligo, M.D.
-
Iris Baccam, MD
-
Jennifer Ann Banek, N.P.
-
McLynda Batterman, FNP-BC
-
Shana J Bean, FNP-BC
-
Anna L Bell, MSN, BSN, RN, FNP-C
-
Jay Gary Bernstein, D.O.
-
Sonia Bertram, FNP-C
-
Sarah Louise Bivens, FNP
-
Megan Blackburn, MD
-
Khy Bradley, MD
-
Tim Bryan, MD
-
Lori Beth Burke, FNP
-
Tracy Elizabeth Burton, FNP-C
-
Emelita Laluan Cabilatazan, MSN-FNP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 03D2266546 | Archwell Health Professional Services of Arizona, | Certificate of waiver | Aug 10, 2026 |
| 03D2266547 | Archwell Health Professional Services of Arizona | Certificate of waiver | Aug 10, 2026 |
| 03D2266719 | Archwell Health Professional Services of Arizona | Certificate of waiver | Aug 14, 2026 |
| 03D2266720 | Archwell Health Professional Services of Arizona | Certificate of waiver | Aug 14, 2026 |
| 03D2266721 | Archwell Health Professional Services of Arizona | Certificate of waiver | Aug 14, 2026 |
| 03D2266725 | Archwell Health Professional Services of Arizona | Certificate of waiver | Aug 14, 2026 |
| 03D2266726 | Archwell Health Professional Services of Arizona | Certificate of waiver | Aug 14, 2026 |
| 03D2266727 | Archwell Health Professional Services of Arizona | Certificate of waiver | Aug 14, 2026 |
| 03D2266922 | Archwell Health Professional Services of Arizona | Certificate of waiver | Aug 16, 2026 |
| 03D2266926 | Archwell Health Professional Services of Arizona | Certificate of waiver | Aug 16, 2026 |
| 03D2266929 | Archwell Health Professional Services of Arizona | Certificate of waiver | Aug 16, 2026 |
| 03D2266930 | Archwell Health Professional Services of Arizona | Certificate of waiver | Aug 16, 2026 |
| 03D2266932 | Archwell Health Professional Services of Arizona | Certificate of waiver | Aug 16, 2026 |
| 03D2315292 | Archwell Health Professional Services of Arizona | Certificate of waiver | Dec 9, 2026 |
| 03D2318318 | Archwell Health Professional Services of Arizona, | Certificate of waiver | Feb 9, 2027 |
| 03D2324966 | Archwell Health Professional Services of Arizona | Certificate of waiver | Jun 3, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20221031001469 | AZ | Part B Supplier - Clinic/Group Practice | 9830566199 |
Receives reassigned benefits from 112 practitioners Practice locations: Tucson, AZ; Phoenix, AZ; Surprise, AZ; Sun City, AZ; Apache Junction, AZ; Mesa, AZ; Peoria, AZ |
National Provider Directory
Locations
725 W Apache Trl
Ste 4
Apache Junction, AZ 85120
Phone (480) 870-7130
1060 E Southern Ave
Ste 106
Mesa, AZ 85204
Phone (480) 870-7400
6843 E Main St
Mesa, AZ 85207
Phone (480) 870-7300
9750 W Peoria Ave
Ste 120
Peoria, AZ 85345
Phone (623) 281-1620
9750 W Peoria Ave
Peoria, AZ 85345
Phone (623) 281-1620
4220 W Bethany Home Rd
Phoenix, AZ 85019
Phone (623) 281-1258
4420 E McDowell Rd
Phoenix, AZ 85008
Phone (602) 858-4295
8913 N 19th Ave
Phoenix, AZ 85021
Phone (602) 858-4361
10050 W Bell Rd
Ste 35
Sun City, AZ 85351
Phone (623) 281-1130
17674 N Litchfield Rd
Surprise, AZ 85374
Phone (623) 281-3001
5100 E Broadway Blvd
Tucson, AZ 85711
Phone (520) 613-3001
2940 S 6th Ave
Tucson, AZ 85713
Phone (520) 613-1001
1740 E Fort Lowell Rd
Ste 100
Tucson, AZ 85719
Phone (520) 613-0001
2265 W Ina Rd
Tucson, AZ 85741
Phone (520) 702-3637
9550 E Golf Links Rd
Ste 100
Tucson, AZ 85730
Phone (520) 910-0207
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Family Medicine) Physician |
207QG0300X | |||
| Internal Medicine Physician |
207R00000X | Yes | ||
| Geriatric Medicine (Internal Medicine) Physician |
207RG0300X |
Addresses
Primary practice location
4315 E Main St
Mesa, AZ 85205-8605
Mailing address
102 Woodmont Blvd Ste 600
Nashville, TN 37205-5250
Other practice location 1
4420 E McDowell Rd
Phoenix, AZ 85008-4504
Phone (602) 858-4295
Other practice location 2
4220 W Bethany Home Rd
Phoenix, AZ 85019-1808
Phone (623) 281-1258
Other practice location 3
10050 W Bell Rd Ste 35
Sun City, AZ 85351-1290
Phone (623) 281-1130
Other practice location 4
8913 N 19th Ave
Phoenix, AZ 85021-4206
Phone (602) 858-4361
Other practice location 5
2940 S 6th Ave
Tucson, AZ 85713-4705
Phone (520) 613-1001
Other practice location 6
5455 E Speedway Blvd
Tucson, AZ 85712-4923
Phone (520) 505-8912
Other practice location 7
6843 E Main St
Mesa, AZ 85207-8207
Phone (480) 870-7300
Other practice location 8
725 W Apache Trl Ste 4
Apache Junction, AZ 85120-3963
Phone (480) 870-7130
Other practice location 9
9550 E Golf Links Rd Ste 100
Tucson, AZ 85730-1400
Phone (520) 910-0207
Other practice location 10
1060 E Southern Ave Ste 106
Mesa, AZ 85204-5058
Phone (480) 870-7400
Other practice location 11
2265 W Ina Rd
Tucson, AZ 85741-2650
Phone (520) 702-3637
Other practice location 12
1740 E Fort Lowell Rd Ste 100
Tucson, AZ 85719-2384
Phone (520) 613-0001
Other practice location 13
17674 N Litchfield Rd
Surprise, AZ 85374-2478
Phone (623) 281-3001
Other practice location 14
9750 W Peoria Ave Ste 120
Peoria, AZ 85345-6108
Phone (623) 281-1620
Other practice location 15
5100 E Broadway Blvd
Tucson, AZ 85711-3762
Phone (520) 613-3001
Other providers in Mesa, AZ
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- Ashley Archer
- Spencer Call Archibald
- Archways Recovery Centers, LLC
- Roxana Arcis
- Joan Ardavanis
- Elizabeth Arellano
- Janet Gonzalez Arellano
- Jesus O Arellano
All providers in Mesa, AZ · Internal Medicine Physician 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 11, 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.