College Medical Center Phoenix LLC

Primary specialty

Psychiatric HospitalTaxonomy code 283Q00000X

Legal business name

COLLEGE MEDICAL CENTER PHOENIX LLC

Practice address

1800 E Van Buren St
Phoenix, AZ 85006-3742

Phone

(562) 923-9449

NPI assigned

Oct 25, 2024

Last updated

Jan 17, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Samuel Einhorn

Title

Owner

Phone

(562) 923-9449

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1841012424. Details of each certification follow.

• CCN 034013 Hospital · Active · Details

Hospital certification: CCN 034013

Legal name

COLLEGE MEDICAL CENTER PHOENIX LLC

Doing business as

COLLEGE MEDICAL CENTER PHOENIX

Certification status

Active

Provider type (POS)

Hospital – Psychiatric

Participating since

Jun 26, 1988

Last certification

Sep 8, 2021

Beds

127

Ownership / control type

Private (for profit)

Most recent change of ownership

Oct 16, 1999 (1 total)

Organization structure

LLCProprietary

Enrollment address

1800 E Van Buren St
Phoenix, AZ 85006-3742
Main/Primary Hospital Location

Hospital subgroups

Psychiatric

Listed as

College Medical Center PhoenixCCN 034013 · All quality measures

Type

Psychiatric

Ownership

Proprietary

Medicare certification status

ActiveFrom the Provider of Services file

Emergency services

No

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

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• CHLB, LLC

  dba College Medical Center

  • General Acute Care Hospital
  • Long Beach, CA
  • NPI 1215373626

  B Weiss Fam TR

  CMS ownership
• CHLB, LLC

  dba Glendora Hospital

  • Psychiatric Hospital
  • Glendora, CA
  • NPI 1487249298

  B Weiss Fam TR

  CMS ownership

Practitioners 6

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.

• Nazila Adib, MD

  • Psychiatry Physician
  • Scottsdale, AZ
  • NPI 1740202613
  NPD (past)
• Roberto Igor Bracamonte Valencia, M.D.

  • Child & Adolescent Psychiatry Physician
  • Phoenix, AZ
  • NPI 1205065299
  NPD (past)
• Gregory Charles Carr, M.D.

  • Psychiatry Physician
  • Scottsdale, AZ
  • NPI 1770760589
  NPD (past)
• Lydia J Cohan, M.D.

  • Child & Adolescent Psychiatry Physician
  • Phoenix, AZ
  • NPI 1700891173
  NPD (past)
• Paul Raymund Valbuena, MD

  • Psychiatry Physician
  • Scottsdale, AZ
  • NPI 1902009145
  NPD (past)
• Adeel Zafar, M.D.

  • Psychiatry Physician
  • Phoenix, AZ
  • NPI 1497950661
  NPD (past)

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

{
    "created_epoch": "1729814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737072000000",
    "number": "1841012424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2104",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906700019",
            "telephone_number": "562-923-9449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 E VAN BUREN ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850063742",
            "telephone_number": "562-923-9449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLEGE MEDICAL CENTER PHOENIX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-25",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A",
        "authorized_official_last_name": "EINHORN",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "562-923-9449"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coll Community Services LLC
• Coll Mentors LLC
• Peter J Colla, P.T.
• Collaborative Technology Solutions LLC
• Elias Joel Collado
• Emily Nichole Collet, RBT
• Arick Collett, OTR/L
• Nicole A Collett
• Rebecca Colley
• David Barrett Collier, DDS

• Psychiatric Hospital in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Psychiatric Hospital in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.