Organization Active NPI

Banner Sun City West Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Sun City, AZ
National Provider Identifier
1760907919
Registry record updated Jul 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
BANNER SUN CITY WEST SURGERY CENTER LLC
Practice address
14416 W Meeker Blvd Ste 103
Sun City, AZ 85375-5284
Phone
(623) 234-3675
Fax
(602) 865-1609
NPI assigned
Aug 9, 2017
Organization subpart
Yes
Parent organization
BANNER HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 26, 2019

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

Authorized official

Name
Matthew Cox
Title
Sr VP Finance
Phone
(602) 747-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

14416 W Meeker Blvd Ste 103
Sun City, AZ 85375-5284

Mailing address

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171109000415 AZ Part B Supplier - Ambulatory Surgical Center 9335405224 Practice locations: Sun City West, AZ

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Banner Sun City West Surgery Center LLCCCN 03C0001291
Medicare certification status
ActiveFrom the Provider of Services file

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
03D2136730Banner Sun City West Surgery Center LLC14416 W Meeker Blvd Ste 103, Sun City West, AZ 85375Certificate of waiverSep 13, 2027

National Provider Directory

National Provider Directory
Part of
M E Lee MD

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

14416 W Meeker Blvd
Ste 1
Sun City West, AZ 85375

14416 W Meeker Blvd
Sun City West, AZ 85375
Phone (623) 583-5083

NPI Registry JSON

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

{
    "created_epoch": "1502236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564099200000",
    "number": "1760907919",
    "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": "14416 W MEEKER BLVD STE 103",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853755284",
            "telephone_number": "623-234-3675",
            "fax_number": "602-865-1609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER SUN CITY WEST SURGERY CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BANNER HEALTH",
        "enumeration_date": "2017-08-09",
        "last_updated": "2019-07-26",
        "status": "A",
        "authorized_official_last_name": "COX",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "SR VP FINANCE",
        "authorized_official_telephone_number": "602-747-4000"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2019; 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.