Community Primary Care LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

COMMUNITY PRIMARY CARE LLC

Practice address

13624 W Camino del Sol Ste 150
Sun City West, AZ 85375-3405

Phone

(623) 328-7087

Fax

(623) 218-1337

NPI assigned

Sep 13, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Aziz Mallik

Title

Managing Partner

Phone

(623) 328-7087

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 2

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

• Melanie Noel Hernandez, FNP-C

  • Family Nurse Practitioner
  • Surprise, AZ
  • NPI 1174018220
  Medicare reassignment NPD
• Amandeep Sodhi, MD

  • Internal Medicine Physician
  • Surprise, AZ
  • NPI 1366419988
  NPD

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

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640131200000",
    "number": "1659041580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12409 W INDIAN SCHOOL RD STE A108",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853929503",
            "telephone_number": "623-328-7087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13624 W CAMINO DEL SOL STE 150",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853753405",
            "telephone_number": "623-328-7087",
            "fax_number": "623-218-1337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-13",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A",
        "authorized_official_last_name": "MALLIK",
        "authorized_official_first_name": "AZIZ",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "623-328-7087",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Clark, PTA
• Clearview Counseling Centers
• Kia Cline, PT
• Clinical Research Institute of Arizona, LLC
• Troy Coleman, DO
• Compudiagnostics Inc
• Kristen Allissa Connelly, PA-C
• Courtney Connolly
• Zachary Ryan Contursi, DO
• Mandi D Conway, MD

• Multi-Specialty Clinic/Center in Sun City West, AZ
• Providers in Sun City West, AZ by specialty
• Multi-Specialty Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; 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.