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Banner Physician Specialists Arizona LLC

Organization Active NPI Durable Medical Equipment & Medical Supplies · Peoria, AZ

NPI 1992073498 · NPPES record last updated Oct 3, 2025

Key facts

NPI
1992073498
Entity type
Organization (NPI type 2)
Primary specialty
Durable Medical Equipment & Medical Supplies 332B00000X
Legal business name
BANNER PHYSICIAN SPECIALISTS ARIZONA LLC
Practice address
13640 N Plaza del Rio Blvd
Peoria, AZ 85381-4846
Phone
(623) 876-3800
NPI assigned
Dec 12, 2011
Organization subpart
Yes
Parent organization (as reported)
BANNER MEDICAL GROUP

Authorized official

Name
Shiva Birdi
Title
Ceo
Phone
(602) 747-4000

Other NPIs with the same Medicare PAC ID 9

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

Corporate family (same tax ID) 21

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

Member of 1

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

Practitioners 371

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 371

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AZ

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20120326000459 AZ DME Supplier - Multi-Specialty - Physician 6204002272 Practice locations: Peoria, AZ

National Provider Directory

Tax ID family
Banner Physician Specialists Arizona LLC (22 organizations share this tax ID)
Part of
Tiffany Weathers

Locations

13640 N Plaza del Rio Blvd
Ste 120
Peoria, AZ 85381
Phone (623) 583-5270

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Yes

Addresses

Primary practice location

13640 N Plaza del Rio Blvd
Peoria, AZ 85381-4846

Mailing address

2901 N Central Ave Ste 160
Phoenix, AZ 85012-2702
Phone (602) 747-4000

Other providers in Peoria, AZ

All providers in Peoria, AZ · Durable Medical Equipment & Medical Supplies in Arizona

Sources for this page

Verify at the official NPI Registry.