Banner Primary Care Physicians Arizona LLC
Organization Active NPI Primary Care Clinic/Center · Phoenix, AZ
NPI 1659640902 · NPPES record last updated Apr 17, 2026
Key facts
- NPI
- 1659640902
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- Legal business name
- BANNER PRIMARY CARE PHYSICIANS ARIZONA LLC
- Practice address
- 2901 N Central Ave Ste 160
Phoenix, AZ 85012-2702 - Phone
- (602) 747-4000
- NPI assigned
- Dec 15, 2011
- Organization subpart
- Yes
- Parent organization (as reported)
- BANNER MEDICAL GROUP
Authorized official
- Name
- Shiva Birdi
- Title
- Ceo
- Phone
- (602) 747-4000
Other NPIs on the same Medicare enrollment 4
Member of 1
Practitioners 327
-
Tamerut Anna Adams, D.O.
-
Parul Agarwal, M.D.
-
Lucas Aidukaitis, DO
-
Ginger D Akins, MSN FNP
-
Ryan Alder, F.N.P.
-
Martha Alemayehu, D.O.
-
Amita Alexander, MD
-
Adelaide Amini, FNP-C
-
Kerry M Amstutz, DO
-
Jacob Scott Anderson, D.O.
-
Tracy Carol Angrick, FNP-C
-
Dena M Arner, FNP-C
-
Sana Ashtiani, M.D.
-
Matthew Li-an Au, MD
-
Michelle Marie Ballecer, M.D., M.P.H.
-
Jasminder Bardin, NP
-
John Michael Benavidez, M.D.
-
Supriya Bhandari, M.D.
-
Marissa Bond, DNP, FNP-C
-
William Bottomley, D.O.
-
Shaun Brancheau, DO
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111115000898 | AZ | Part B Supplier - Clinic/Group Practice | 6406020155 |
Receives reassigned benefits from 280 practitioners 4 other NPIs on this 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
- Part of
- Tiffany Weathers
Locations
3235 N Hunt Hwy
Ste 103
Florence, AZ 85132
Phone (520) 233-2770
101 E State Highway 260
Payson, AZ 85541
Phone (928) 478-8905
37100 N Gantzel Rd
Ste 201
San Tan Vly, AZ 85140
Phone (480) 394-4469
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | Yes |
Addresses
Primary practice location
2901 N Central Ave Ste 160
Phoenix, AZ 85012-2702
Mailing address
2901 N Central Ave Ste 160
Phoenix, AZ 85012-2702
Other practice location 1
807 S Ponderosa St
Payson, AZ 85541-5542
Phone (928) 471-3222
Other practice location 2
37100 N Gantzel Rd Ste 201
Queen Creek, AZ 85140-7352
Phone (928) 596-4500
Other practice location 3
1075 S Idaho Rd Ste 206
Apache Junction, AZ 85119-6405
Phone (480) 827-5005
Other practice location 4
1811 E McMurray Blvd
Casa Grande, AZ 85122-5404
Phone (520) 374-6530
Other practice location 5
120 E Main St Ste A
Payson, AZ 85541-5618
Phone (928) 596-4700
Other practice location 6
1760 E Florence Blvd Ste 100
Casa Grande, AZ 85122-4765
Phone (520) 374-6505
Other practice location 7
6152 W Hardscrabble Mesa Rd
Pine, AZ 85544-5238
Phone (928) 596-4848
Other practice location 8
1780 E Florence Blvd Ste 108
Casa Grande, AZ 85122-4782
Phone (520) 381-6090
Other practice location 9
17900 N Porter Rd
Maricopa, AZ 85138-4228
Phone (520) 233-2500
Other practice location 10
3235 N Hunt Hwy Ste 103
Florence, AZ 85132-6898
Phone (520) 233-2770
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417238908 | Other | MEDICAID NPI | |
| 646019 | Medicaid | AZ |
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All providers in Phoenix, AZ · Primary Care Clinic/Center in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 17, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.