Banner Physician Super Specialists Arizona LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

BANNER PHYSICIAN SUPER SPECIALISTS ARIZONA LLC

Practice address

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

Phone

(602) 747-4000

NPI assigned

Sep 26, 2011

Last updated

Apr 17, 2026By the provider in NPPES

Organization subpart

Yes

Parent organization

BANNER MEDICAL GROUPAs reported in NPPES

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

Authorized official

Name

Shiva Birdi

Title

Ceo

Phone

(602) 747-4000

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

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

• Banner Physician Super Specialists Arizona LLC

  • Durable Medical Equipment & Medical Supplies
  • Glendale, AZ
  • NPI 1346062205

  7911173794

  Same PAC ID
• Banner Physician Super Specialists Arizona LLC

  • Durable Medical Equipment & Medical Supplies
  • Mesa, AZ
  • NPI 1386462810

  7911173794

  Same PAC ID

Other NPIs on the same Medicare enrollment 3

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

• Banner Physician Super Specialists Arizona LLC

  • Multi-Specialty Clinic/Center
  • San Tan Valley, AZ
  • NPI 1396014403

  O20111228000353

  Same enrollment
• Banner Physician Super Specialists Arizona LLC

  • Nutrition Education Nutritionist
  • Glendale, AZ
  • NPI 1578125738

  O20111228000353

  Same enrollment
• Banner Physician Super Specialists Arizona LLC

  • Nutrition Education Nutritionist
  • Mesa, AZ
  • NPI 1790337665

  O20111228000353

  Same enrollment

Part of

Tiffany Weathers

Locations

Practitioners 221

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.

• Troy M Lam, D.D.S., M.D.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Glendale, AZ
  • NPI 1851706048
  Medicare reassignment Care Compare group NPD
• Daniel E Miga, MD

  • Pediatric Cardiology Physician
  • Mesa, AZ
  • NPI 1063455178
  Medicare reassignment Care Compare group NPD
• Andrew Valenzuela, MD

  • Sleep Medicine (Internal Medicine) Physician
  • Glendale, AZ
  • NPI 1851889232
  Medicare reassignment Care Compare group NPD
• Ravindra Kumar Vegunta, MBBS., FRCSED.

  • Pediatric Surgery Physician
  • Mesa, AZ
  • NPI 1346280203
  Medicare reassignment Care Compare group NPD
• Louis Pak-Shun Vu, M.D.

  • Pediatric Orthopaedic Surgery Physician
  • Glendale, AZ
  • NPI 1184605859
  Medicare reassignment Care Compare group NPD
• Rahel Zubairi, MD

  • Specialist
  • Columbia, MD
  • NPI 1871535088

  AZ

  Medicare reassignment Care Compare group NPD
• Nikita George Alexiades, M.D.

  • Neurological Surgery Physician
  • Mesa, AZ
  • NPI 1548603053
  Medicare reassignment NPD
• Pablo Andres Angulo, D.O.

  • Pediatric Hematology & Oncology Physician
  • Phoenix, AZ
  • NPI 1902122120
  Medicare reassignment NPD
• Anthony Ikechukwu Ani, MD

  • Pediatrics Physician
  • Mesa, AZ
  • NPI 1265619373
  Medicare reassignment NPD
• Savannah Michelle Apodaca, FNP-C

  • Family Nurse Practitioner
  • Phoenix, AZ
  • NPI 1275050270
  Medicare reassignment NPD
• Amy L Ariss-Martin, AU.D.

  • Audiologist
  • Phoenix, AZ
  • NPI 1710057450
  Medicare reassignment NPD
• Melissa Jayne Assaf, CPNP-PC DNP

  • Pediatric Nurse Practitioner
  • Glendale, AZ
  • NPI 1740586593
  Medicare reassignment NPD

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

{
    "created_epoch": "1316995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776384000000",
    "number": "1841573870",
    "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": "2901 N CENTRAL AVE STE 160",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122702",
            "telephone_number": "602-747-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5555 W Thunderbird Rd",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853064622",
            "country_code": "US",
            "telephone_number": "602-865-5561",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5601 W Eugie Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853041256",
            "country_code": "US",
            "telephone_number": "602-865-4510",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5757 W Thunderbird Rd Ste E250",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853065613",
            "country_code": "US",
            "telephone_number": "602-865-4470",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6644 E Baywood Ave",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852061747",
            "country_code": "US",
            "telephone_number": "480-321-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7575 E Earll Dr",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852516915",
            "country_code": "US",
            "telephone_number": "480-448-7500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9305 W Thomas Rd Ste 125",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850373359",
            "country_code": "US",
            "telephone_number": "602-865-4065",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9305 W Thomas Rd Ste 380",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850373368",
            "country_code": "US",
            "telephone_number": "623-327-4144",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1760 E Florence Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Casa Grande",
            "state": "AZ",
            "postal_code": "851224765",
            "country_code": "US",
            "telephone_number": "520-374-6505",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17900 N Porter Rd",
            "address_purpose": "LOCATION",
            "city": "Maricopa",
            "state": "AZ",
            "postal_code": "851384228",
            "country_code": "US",
            "telephone_number": "520-233-2500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1811 E McMurray Blvd",
            "address_purpose": "LOCATION",
            "city": "Casa Grande",
            "state": "AZ",
            "postal_code": "851225404",
            "country_code": "US",
            "telephone_number": "520-374-6530",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2050 W Southern Ave",
            "address_purpose": "LOCATION",
            "city": "Apache Junction",
            "state": "AZ",
            "postal_code": "851207305",
            "country_code": "US",
            "telephone_number": "480-733-3300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "37000 N Gantzel Rd",
            "address_purpose": "LOCATION",
            "city": "Queen Creek",
            "state": "AZ",
            "postal_code": "851407303",
            "country_code": "US",
            "telephone_number": "480-394-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "37100 N Gantzel Rd Ste 214",
            "address_purpose": "LOCATION",
            "city": "Queen Creek",
            "state": "AZ",
            "postal_code": "851407353",
            "country_code": "US",
            "telephone_number": "480-733-7350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1111 E McDowell Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850062612",
            "country_code": "US",
            "telephone_number": "602-839-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 S Dobson Rd",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852024707",
            "country_code": "US",
            "telephone_number": "480-412-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1432 S Dobson Rd Ste 206",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852024771",
            "country_code": "US",
            "telephone_number": "480-827-5540",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1432 S Dobson Rd Ste 209",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852024771",
            "country_code": "US",
            "telephone_number": "480-412-6970",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1432 S Dobson Rd Ste 301",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852024773",
            "country_code": "US",
            "telephone_number": "480-412-9400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1432 S Dobson Rd Ste 304",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852024773",
            "country_code": "US",
            "telephone_number": "480-412-7400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1432 S Dobson Rd Ste 402",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852024777",
            "country_code": "US",
            "telephone_number": "480-412-5550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1432 S Dobson Rd Ste 403",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852024777",
            "country_code": "US",
            "telephone_number": "480-412-7473",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1432 S Dobson Rd Ste 408",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852024777",
            "country_code": "US",
            "telephone_number": "480-412-7486",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1432 S Dobson Rd Ste 506",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852024778",
            "country_code": "US",
            "telephone_number": "480-412-6430",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1432 S Dobson Rd Ste 501",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852024778",
            "country_code": "US",
            "telephone_number": "480-412-7474",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1432 S Dobson Rd Ste 509",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852024778",
            "country_code": "US",
            "telephone_number": "480-412-6970",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1435 S Alma School Rd",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852867144",
            "country_code": "US",
            "telephone_number": "480-668-1600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1432 S Dobson Rd Ste 512",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852024778",
            "country_code": "US",
            "telephone_number": "480-412-6336",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1450 S Dobson Rd Ste B221",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852024745",
            "country_code": "US",
            "telephone_number": "480-827-5370",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "155 E Warner Rd",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852963082",
            "country_code": "US",
            "telephone_number": "480-649-6600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1920 N Higley Rd Ste 308",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852341625",
            "country_code": "US",
            "telephone_number": "480-543-6600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20751 W Market St",
            "address_purpose": "LOCATION",
            "city": "Buckeye",
            "state": "AZ",
            "postal_code": "853967893",
            "country_code": "US",
            "telephone_number": "623-463-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21772 S Ellsworth Loop Rd",
            "address_purpose": "LOCATION",
            "city": "Queen Creek",
            "state": "AZ",
            "postal_code": "851427709",
            "country_code": "US",
            "telephone_number": "480-512-3700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4375 E Irma Ln",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850504312",
            "country_code": "US",
            "telephone_number": "480-980-5800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5310 W Thunderbird Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853064709",
            "country_code": "US",
            "telephone_number": "602-865-4065",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5310 W Thunderbird Rd Ste 214",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853064722",
            "country_code": "US",
            "telephone_number": "602-865-4480",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14502 W Meeker Blvd",
            "address_purpose": "LOCATION",
            "city": "Sun City West",
            "state": "AZ",
            "postal_code": "853755282",
            "country_code": "US",
            "telephone_number": "623-524-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5310 W Thunderbird Rd Ste 301",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853064710",
            "country_code": "US",
            "telephone_number": "602-865-4442",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5310 W Thunderbird Rd Ste 308",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853064710",
            "country_code": "US",
            "telephone_number": "602-865-4442",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5310 W Thunderbird Rd Ste 310",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853064710",
            "country_code": "US",
            "telephone_number": "602-865-4470",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5310 W Thunderbird Rd Ste 311",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853064710",
            "country_code": "US",
            "telephone_number": "602-865-4230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BANNER PHYSICIAN SUPER SPECIALISTS ARIZONA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BANNER MEDICAL GROUP",
        "enumeration_date": "2011-09-26",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A",
        "authorized_official_last_name": "BIRDI",
        "authorized_official_first_name": "SHIVA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-747-4000"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "646532",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• 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
• Banner Primary Care Physicians Arizona LLC
• Banner Primary Care Physicians Arizona LLC
• Banner Primary Care Physicians Arizona LLC
• Banner Primary Care Physicians Arizona LLC
• Banner Primary Care Physicians Arizona LLC

• Multi-Specialty Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Multi-Specialty 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.