NPIMap

Organization Active NPI

Banner Primary Care Physicians Arizona LLC

  • Clinical Medical Laboratory
  • Peoria, AZ
National Provider Identifier
1649544362
Registry record updated Apr 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
BANNER PRIMARY CARE PHYSICIANS ARIZONA LLC
Practice address
13640 N Plaza del Rio Blvd
Ste 102
Peoria, AZ 85381-4846
Phone
(623) 876-3928
NPI assigned
Feb 27, 2012
Organization subpart
Yes
Parent organization
BANNER MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 17, 2026

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

Authorized official

Name
Shiva Birdi
Title
Ceo
Phone
(602) 747-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

13640 N Plaza del Rio Blvd
Ste 102
Peoria, AZ 85381-4846

Mailing address

2901 N Central Ave Ste 160
Phoenix, AZ 85012-2702

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 71

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 71

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111115000898 AZ Part B Supplier - Clinic/Group Practice 6406020155 Receives reassigned benefits from 280 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Page, AZ; Payson, AZ; Peoria, AZ; Phoenix, AZ; Goodyear, AZ; Queen Creek, AZ; San Tan Valley, AZ; Scottsdale, AZ…

National Provider Directory

National Provider Directory
Tax ID family
Banner Primary Care Physicians Arizona LLC24 organizations share this tax ID, including this one
Part of
Tiffany Weathers

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

Locations

13640 N Plaza del Rio Blvd
Ste 102
Peoria, AZ 85381
Phone (623) 876-3928

4720 E Greenway Rd
Phoenix, AZ 85032
Phone (602) 439-6000

NPI Registry JSON

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

{
    "created_epoch": "1330300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776384000000",
    "number": "1649544362",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13640 N PLAZA DEL RIO BLVD",
            "address_2": "STE 102",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814846",
            "telephone_number": "623-876-3928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER PRIMARY CARE PHYSICIANS ARIZONA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BANNER MEDICAL GROUP",
        "enumeration_date": "2012-02-27",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A",
        "authorized_official_last_name": "BIRDI",
        "authorized_official_first_name": "SHIVA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-747-4000"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 17, 2026; 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.