NPIMap

Organization Active NPI

Innovative Primary Care LLC

  • Legal Medicine
  • Gilbert, AZ
National Provider Identifier
1669437349
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
23910 Issued in AZ
Legal business name
INNOVATIVE PRIMARY CARE LLC
Practice address
2915 E Baseline Rd
#101
Gilbert, AZ 85234-2425
Phone
(480) 776-0626
Fax
(480) 776-0627
NPI assigned
Apr 18, 2006
Last updated
Oct 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Authorized official

Name
Dr. Sandra Lynn Levitt, M.D.NPI 1225224660
Title
Owner
Phone
(480) 776-0626

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal MedicineGroup: 193400000X SINGLE SPECIALTY GROUP 173000000X 23910 AZ Primary

Addresses

Primary practice location

2915 E Baseline Rd
#101
Gilbert, AZ 85234-2425

Mailing address

2915 E Baseline Rd
#101
Gilbert, AZ 85234-2425
Phone (480) 776-0626

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050801000274 AZ Part B Supplier - Clinic/Group Practice 9032147095 Receives reassigned benefits from 13 practitioners
Practice locations: Gilbert, AZ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D1042934Innovative Primary Care2915 E Baseline Rd, Gilbert, AZ 85234Certificate of waiverJul 11, 2027

National Provider Directory

National Provider Directory

Locations

2915 E Baseline Rd
Ste 101
Gilbert, AZ 85234
Phone (480) 776-0626

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761609600000",
    "number": "1669437349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 E BASELINE RD",
            "address_2": "#101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342425",
            "telephone_number": "480-776-0626",
            "fax_number": "480-776-0627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2915 E BASELINE RD",
            "address_2": "#101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342425",
            "telephone_number": "480-776-0626",
            "fax_number": "480-776-0627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-18",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A",
        "authorized_official_last_name": "LEVITT",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-776-0626",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Legal Medicine",
            "state": "AZ",
            "license": "23910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.