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CANYON PEDIATRICS, INC
NPI 1053176677
Pediatrics in Gilbert, AZ

Active since February 14, 2024CLIA Certified · 3 labs
2451 E BASELINE RD STE 200, GILBERT, AZ 85234(480) 776-7155 Get Directions Write a Review

NPPES record last updated: March 17, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Canyon Pediatrics, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CANYON PEDIATRICS, INC (NPI 1053176677) is a healthcare organization registered as a pediatrics in Gilbert, Arizona and active in the NPI registry since February 2024. The organization holds 3 active CLIA laboratory certificates and lists Richard Brubaker, Ceo, as its authorized official.

NPPES Registry Identity

NPI1053176677
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameCANYON PEDIATRICS, INC
Location Address2451 E BASELINE RD STE 200Gilbert, AZ 85234-2405
Mailing Address2451 E Baseline Rd Ste 130Gilbert, AZ 85234-2487 · (480) 776-7155
Phone(480) 776-7155
Organization SubpartNo
Authorized OfficialRichard BrubakerCeo · (480) 507-2199
Enumeration DateFebruary 14, 2024
Last NPPES UpdateMarch 17, 2025
NPPES CertifiedMarch 17, 2025
✔ NPI 1053176677 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X
2451 E BASELINE RD STE 200, Gilbert, AZ 85234
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Other Identifiers 1

Medicaid053504AZ

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D2190425

Canyon Pediatrics & Family · Gilbert, AZ
Active · expires Aug 12, 2026
CLIA Number03D2190425
Laboratory TypePhysician Office
Certificate Effective DateAugust 13, 2024
Certificate Expiration DateAugust 12, 2026
Laboratory DirectorRobert Kosiorek
Laboratory Phone(480) 507-2199
Laboratory LocationCanyon Pediatrics & Family2451 E Baseline Rd Ste 130, Gilbert, AZ 85234
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 03D0956774

Canyon Pediatrics · Gilbert, AZ
Active · expires Feb 3, 2027
CLIA Number03D0956774
Laboratory TypeOther
Certificate Effective DateFebruary 4, 2025
Certificate Expiration DateFebruary 3, 2027
Laboratory DirectorRobert Kosiorek
Laboratory Phone(480) 507-2199
Laboratory LocationCanyon Pediatrics2451 E Baseline, Ste 200, Gilbert, AZ 85234
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 03D0528634

Canyon Pediatrics · Mesa, AZ
Active · expires Aug 31, 2026
CLIA Number03D0528634
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorRobert Kosiorek
Laboratory Phone(480) 507-2199
Laboratory LocationCanyon Pediatrics815 E University Dr, Mesa, AZ 85203
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RICHARD BRUBAKER LMSW
Social Worker
2451 E BASELINE RD STE 200
GILBERT, AZ 85234
Maricopa County (480) 507-2213
ASHLEY BRUBAKER LMSW, PMH-C, IBCLC
Social Worker
2451 E BASELINE RD STE 200
GILBERT, AZ 85234
Maricopa County (480) 507-2199
MS. NATALIE CHRISTINE MONK PNP
Nurse Practitioner (Pediatrics)
2451 E BASELINE RD STE 200
GILBERT, AZ 85234
Maricopa County (480) 507-2219
TRUDE HENDRICKSON LCSW
Social Worker (Clinical)
2451 E BASELINE RD STE 200
GILBERT, AZ 85234
Maricopa County (480) 507-2199

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Canyon Pediatrics, Inc's NPI number?

The NPI number for Canyon Pediatrics, Inc is 1053176677. It was assigned to this organization in the NPPES registry on February 14, 2024.

Where is Canyon Pediatrics, Inc located?

Canyon Pediatrics, Inc is located at 2451 E Baseline Rd Ste 200, Gilbert, AZ 85234. The listed phone number is (480) 776-7155.

What is Canyon Pediatrics, Inc's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Canyon Pediatrics, Inc hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Canyon Pediatrics, Inc was last updated on March 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.