Banner Phoenix Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

BANNER PHOENIX SURGERY CENTER LLC

Practice address

1111 E McDowell Rd Ste B
Phoenix, AZ 85006-2612

Phone

(602) 368-3854

Fax

(602) 865-7261

NPI assigned

Aug 9, 2017

Last updated

Apr 17, 2026By the provider in NPPES

Organization subpart

Yes

Parent organization

BANNER HEALTHAs reported in NPPES

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

Authorized official

Name

Patrick Penrose

Title

VP

Phone

(602) 747-4000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Listed as

Banner Phoenix Surgery Center LLCCCN 03C0001001

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Part of

Big Horn Family Med

Member of 1

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

• Banner Health

  dba Banner Hospice of Northern Colorado

  • Community Based Hospice Care Agency
  • Greeley, CO
  • NPI 1407409964

  Member Of

  NPD member

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

{
    "created_epoch": "1502236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776384000000",
    "number": "1770008922",
    "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": "1111 E MCDOWELL RD STE B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062612",
            "telephone_number": "602-368-3854",
            "fax_number": "602-865-7261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER PHOENIX SURGERY CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BANNER HEALTH",
        "enumeration_date": "2017-08-09",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A",
        "authorized_official_last_name": "PENROSE",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "602-747-4000"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Banner Pharmacy Services LLC
• Banner Pharmacy Services LLC (Banner Family Pharmacy - Estrella)
• Banner Pharmacy Services LLC
• Banner Pharmacy Services LLC (Banner Family Pharmacy-Univ. Med. Institute 1441)
• Banner Phoenix Internal Medicine Physicians
• Banner Physician Specialists Arizona LLC
• Banner Physician Specialists Arizona LLC
• Banner Physician Specialists Arizona LLC
• Banner Physician Specialists Arizona LLC
• Banner Physician Specialists Arizona LLC

• Ambulatory Surgical Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Ambulatory Surgical Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.