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AVISTA MEDICAL CENTER & WEIGHT LOSS
NPI 1073807202
Family Medicine in Gilbert, AZ

Active since June 06, 2011CLIA 03D1013102 · Waiver
690 E WARNER RD STE 133, GILBERT, AZ 85296(480) 892-1212(480) 892-4941 Get Directions Write a Review

NPPES record last updated: February 8, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 8, 2022, Nov 18, 2019 (2 updates tracked since 2019).

About Avista Medical Center & Weight Loss NPPES

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

AVISTA MEDICAL CENTER & WEIGHT LOSS (NPI 1073807202) is a healthcare organization registered as a family medicine in Gilbert, Arizona and active in the NPI registry since June 2011. The organization holds a CLIA Waiver certificate valid through December 30, 2026 and lists Chad Gammage, Ceo, as its authorized official.

NPPES Registry Identity

NPI1073807202
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePUNYAKAM PLLC
Location Address690 E WARNER RD STE 133Gilbert, AZ 85296-3057
Mailing Address690 E Warner Rd Ste 133Gilbert, AZ 85296-3057 · (480) 892-1212 · Fax (480) 892-4941
Phone(480) 892-1212
Fax(480) 892-4941
Organization SubpartNo
Authorized OfficialChad GammageCeo · (480) 892-1212
Enumeration DateJune 6, 2011
Last NPPES UpdateFebruary 8, 20222 updates tracked since enumeration
NPPES CertifiedFebruary 8, 2022
✔ NPI 1073807202 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in AZ · 28418
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
690 E WARNER RD STE 133, Gilbert, AZ 85296
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Other Names 1

Doing Business AsAvista Medical Center & Weight Loss

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

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 03D1013102

Avista Medical Center · Gilbert, AZ
Active · expires Dec 30, 2026
CLIA Number03D1013102
Laboratory TypePhysician Office
Certificate Effective DateDecember 31, 2024
Certificate Expiration DateDecember 30, 2026
Laboratory DirectorPunya Raman
Laboratory Phone(480) 892-1212
Laboratory LocationAvista Medical Center690 E Warner Rd, #133, Gilbert, AZ 85296
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

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

PUNYA RAMAN GAMMAGE MD
Family Medicine
690 E WARNER RD STE 133
GILBERT, AZ 85296
Maricopa County (480) 892-1212

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 Punyakam PLLC's NPI number?

The NPI number for Punyakam PLLC is 1073807202. It was assigned to this organization in the NPPES registry on June 6, 2011. The provider is doing business as Avista Medical Center & Weight Loss.

Where is Punyakam PLLC located?

Punyakam PLLC is located at 690 E Warner Rd Ste 133, Gilbert, AZ 85296. The listed phone number is (480) 892-1212.

What is Punyakam PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Punyakam PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D1013102) is associated with this NPI, valid through December 30, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Punyakam PLLC was last updated on February 8, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.