NPIMap

Organization Active NPI

Maricopa County Special Health Care District

Doing business as Maricopa Integrated Health

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Peoria, AZ
National Provider Identifier
1821415902
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
H3673 Issued in AZ
Legal business name
MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT
Doing business as
Maricopa Integrated Health
Valleywise Comprehensive Health Center - Peoria
Practice address
8088 W Whitney Dr
Peoria, AZ 85345-6564
Phone
(833) 855-9973
NPI assigned
Mar 26, 2014
Last updated
Jun 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Authorized official

Name
Pamela S Fowler
Title
System Director of Reimbursement
Phone
(602) 344-2830

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X H3673 AZ Primary

Addresses

Primary practice location

8088 W Whitney Dr
Peoria, AZ 85345-6564

Mailing address

PO Box 29670
Phoenix, AZ 85038-9670
Phone (602) 344-8178

Other identifiers 7

IdentifierTypeStateIssuer
AZ0205850OtherAZBLUE CROSS BLUE SHIELD
631935OtherAZAETNA
29517OtherAZPHOENIX INDIAN MEDICAL CENTER
500005OtherAZEVERCARE CHOICE
987495MedicaidAZ
AZ0947OtherAZHEALTHNET OF AZ
189350800OtherAZUD DEPT OF LABOR

Other names 2

  • Maricopa Integrated Health Doing business as
  • Valleywise Comprehensive Health Center - Peoria Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040513001268 AZ Part A Provider - End-Stage Renal Disease Facility (ESRD) 4688583651 1 other NPI on this enrollment
Practice locations: Peoria, AZ

Other NPIs with the same Medicare PAC ID 13

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 13

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
033504 Valleywise Comprehensive Health Center-Peoria Outpatient DialysisCCN 033504
Overall star rating
4.0 of 5
Ownership
Non-profit
Certified
Jun 1, 2017
Medicare certification status
ActiveFrom the Provider of Services file
Dialysis stations
13

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

National Provider Directory

National Provider Directory
Tax ID family
Maricopa County Special Health Care District23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

Ownership & related parties

All facility ownership & control disclosures 13

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Valleywise HealthPhoenix, AZ, CCN 03S022 Hospital Operational/Managerial Control Jan 1, 2005
Valleywise HealthPhoenix, AZ, CCN 030022 Hospital Operational/Managerial Control (100%) Jan 1, 2005
Valleywise Comprehensive Health Center - PeoriaPeoria, AZ, CCN 031073 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2005
Valleywise Community Health Center - McDowellPhoenix, AZ, CCN 031065 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2005
Valleywise Health Community Health Center - GuadalupeGuadalupe, AZ, CCN 031066 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2005
Valleywise Community Health Center - North PhoenixPhoenix, AZ, CCN 031067 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2005
Valleywise Community Health Center - West MaryvalePhoenix, AZ, CCN 031075 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2005
Valleywise Comprehensive Health Center - PhoenixPhoenix, AZ, CCN 031072 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2005
Valleywise Community Health Center - South Phoenix LaveenPhoenix, AZ, CCN 031071 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2005
Valleywise Community Health Center - ChandlerChandler, AZ, CCN 031082 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2005
Valleywise Community Health Center - AvondaleAvondale, AZ, CCN 031080 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2005
Valleywise Community Health Center - MesaMesa, AZ, CCN 031074 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2005
Valleywise Community Health Center - South CentralPhoenix, AZ, CCN 031083 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2005

Owned or controlled facilities with NPI records 18

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1395792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687305600000",
    "number": "1821415902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29670",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850389670",
            "telephone_number": "602-344-8178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8088 W WHITNEY DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853456564",
            "telephone_number": "833-855-9973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-26",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "SYSTEM DIRECTOR OF REIMBURSEMENT",
        "authorized_official_telephone_number": "602-344-2830"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "AZ",
            "license": "H3673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "AZ0205850",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "631935",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHOENIX INDIAN MEDICAL CENTER",
            "identifier": "29517",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE CHOICE",
            "identifier": "500005",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "987495",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET OF AZ",
            "identifier": "AZ0947",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UD DEPT OF LABOR",
            "identifier": "189350800",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maricopa Integrated Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Valleywise Comprehensive Health Center - Peoria",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.