NPIMap

Organization Active NPI

Denova Collaborative Health, LLC

  • Multi-Specialty Clinic/Center
  • Avondale, AZ
National Provider Identifier
1689153769
Registry record updated Jun 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
OTC9070 Issued in AZ
Legal business name
DENOVA COLLABORATIVE HEALTH, LLC
Doing business as
Denova Collaborative Health, LLC
Practice address
506 E Western Ave Ste 104
Avondale, AZ 85323-2422
Phone
(602) 230-7373
Fax
(602) 230-3086
NPI assigned
Aug 9, 2018
Last updated
Jun 26, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2026

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

Authorized official

Name
Laura Ratto
Title
Director Quality & Credentialing
Phone
(602) 230-7373

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X OTC9070 AZ Primary

Addresses

Primary practice location

506 E Western Ave Ste 104
Avondale, AZ 85323-2422

Mailing address

3101 N Central Ave Ste 550
Phoenix, AZ 85012-2635
Phone (602) 230-7373

Other identifiers 1

IdentifierTypeStateIssuer
494475MedicaidAZ

Other names 1

  • Denova Collaborative Health, LLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040621001542 AZ Part B Supplier - Clinic/Group Practice 2466437736 Receives reassigned benefits from 304 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tucson, AZ; Phoenix, AZ; Mesa, AZ; Peoria, AZ; Avondale, AZ

Other NPIs on the same Medicare enrollment 8

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

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
03D2149315Denova Collaborative Health - Avondale506 E Western Ave Ste 104, Avondale, AZ 85323Certificate of waiverMay 30, 2028

National Provider Directory

National Provider Directory
Tax ID family
Bayless Healthcare Group6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Practitioners & affiliated clinicians

Practitioners 47

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 47

NPI Registry JSON

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

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782432000000",
    "number": "1689153769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 N CENTRAL AVE STE 550",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122635",
            "telephone_number": "602-230-7373",
            "fax_number": "602-682-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 E WESTERN AVE STE 104",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853232422",
            "telephone_number": "602-230-7373",
            "fax_number": "602-230-3086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENOVA COLLABORATIVE HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-09",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A",
        "authorized_official_last_name": "RATTO",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "DIRECTOR QUALITY & CREDENTIALING",
        "authorized_official_telephone_number": "602-230-7373"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "AZ",
            "license": "OTC9070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "494475",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Denova Collaborative Health, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Avondale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2026; 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.