PHOENIX INDIAN MEDICAL CENTER
NPI 1083643738
Public Health or Welfare in Phoenix, AZ

Q: What is Dhew Ind Hlth Sv Hlth Svs & Mntl Hlth Adm's specialty?

The primary specialty registered for this NPI is Public Health or Welfare with taxonomy code 251K00000X.

Active since July 02, 2006CLIA Certified · 2 labs

4212 N 16TH ST, PHOENIX, AZ 85016(602) 263-1200(602) 200-5383 Get Directions Write a Review

NPPES record last updated: March 19, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 26, 2021, Jun 18, 2019, Nov 13, 2017 (3 updates tracked since 2017).

On this page

About Phoenix Indian Medical Center NPPES

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

PHOENIX INDIAN MEDICAL CENTER (NPI 1083643738) is a healthcare organization registered as a public health or welfare in Phoenix, Arizona and active in the NPI registry since July 2006. The organization holds 2 active CLIA laboratory certificates and lists Laura A Tillman, Cmo, as its authorized official.

NPPES Registry Identity

NPI1083643738

Entity TypeOrganization

Primary Taxonomy251K00000X

Legal Business NameDHEW IND HLTH SV HLTH SVS & MNTL HLTH ADM

Location Address4212 N 16TH STPhoenix, AZ 85016-5319

Mailing AddressPo Box 95460Cleveland, OH 44101-0033 · (602) 581-6088 · Fax (602) 263-1619

Phone(602) 263-1200

Fax(602) 200-5383

Organization SubpartNo

Authorized OfficialLaura A TillmanCmo · (602) 581-6080

Enumeration DateJuly 2, 2006

Last NPPES UpdateMarch 19, 20243 updates tracked since enumeration

NPPES CertifiedMarch 19, 2024

✔ NPI 1083643738 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPublic Health or WelfareAgencies

Taxonomy Code251K00000X

4212 N 16TH ST, Phoenix, AZ 85016

Open in Google Maps ↗

Other Names 1

Doing Business AsPhoenix Indian Medical Center

Other Identifiers 5

Medicaid537821AZ

OtherP0206550AZ · Blue Cross

Medicaid418196AZ

Medicaid022062AZ

Medicaid092354AZ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, UnitedHealthcare.Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

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 Accreditation 03D0860951

Phoenix Indian Medical Center Blood Gas Lab - Respiratory Therapy · Phoenix, AZ

Active · expires Aug 16, 2027

CLIA Number03D0860951

Laboratory TypeAncillary Testing Site In Health Care Center

Certificate Effective DateAugust 17, 2025

Certificate Expiration DateAugust 16, 2027

Laboratory DirectorDr. Suzanne L. Belzer

Laboratory Phone(602) 263-1565

Laboratory LocationPhoenix Indian Medical Center Blood Gas Lab - Respiratory Therapy4212 North 16th Street, Phoenix, AZ 85016

CLIA data matches this NPI record on: Address Name

This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Accreditation 03D0664433

Phoenix Indian Medical Center · Phoenix, AZ

Active · expires Feb 8, 2027

CLIA Number03D0664433

Laboratory TypeHospital

Certificate Effective DateFebruary 9, 2025

Certificate Expiration DateFebruary 8, 2027

Laboratory DirectorDr. Carl M. Minami

Laboratory Phone(602) 581-6268

Laboratory LocationPhoenix Indian Medical Center4212 N 16th St, Phoenix, AZ 85016

CLIA data matches this NPI record on: Address Name

This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 20

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

WENDY RAZO

Registered Nurse (Obstetric, High-Risk)