NPIMap

Organization Active NPI

Banner Physician Specialists Arizona LLC

  • Durable Medical Equipment & Medical Supplies
  • Peoria, AZ
National Provider Identifier
1992073498
Registry record updated Oct 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 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
Last updated
Oct 3, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
BANNER MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 3, 2025

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

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

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

Medicare participation

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

Enrollment records 1

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

Other NPIs with the same Medicare PAC ID 9

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

National Provider Directory

National Provider Directory
Tax ID family
Kevin Warren22 organizations share this tax ID, including this one
Part of
Tiffany Weathers

Other organizations with this tax ID 21

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

View all 21

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

Locations

13640 N Plaza del Rio Blvd
Ste 120
Peoria, AZ 85381
Phone (623) 876-3870

NPI Registry JSON

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

{
    "created_epoch": "1323648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759449600000",
    "number": "1992073498",
    "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",
            "telephone_number": "602-747-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13640 N PLAZA DEL RIO BLVD",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814846",
            "telephone_number": "623-876-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER PHYSICIAN SPECIALISTS ARIZONA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BANNER MEDICAL GROUP",
        "enumeration_date": "2011-12-12",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "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": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2025; 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.