Active NPI
Banner Sun City West Surgery Center LLC
- Ambulatory Surgical Clinic/Center
- Sun City, AZ
National Provider Identifier
1760907919
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- 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 HEALTH
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 LLC
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 03D2136730 | Banner Sun City West Surgery Center LLC | Certificate of waiver | Sep 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
- Banner Imaging Services LLC
- Banner Pharmacy Services LLC
- Banner Pharmacy Services LLC
- Banner Sun City Medical Group
- Banner Sun City Neurological and Surgical Specialists
- Banner Thunderbird Medical Center
- Banner Thunderbird Medical Center
- Sharon Barber
- Dagny Yuuki Barclay, OTD, OTR/L
- Barnet Dulaney Perkins Eye Center, PC
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.