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SPRINGFIELD PEDIATRICS
NPI 1093019150
Pediatrics in San Tan Valley, AZ

Active since January 04, 2011CLIA 03D2042356 · Waiver
36351 N GANTZEL RD STE 127, SAN TAN VALLEY, AZ 85140(602) 734-5509(877) 281-3385 Get Directions Write a Review

NPPES record last updated: July 25, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Springfield Pediatrics NPPES

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

SPRINGFIELD PEDIATRICS (NPI 1093019150) is a healthcare organization registered as a pediatrics in San Tan Valley, Arizona and active in the NPI registry since January 2011. The organization holds a CLIA Waiver certificate valid through June 10, 2028 and lists Oladiji G Vaughan, Owner, as its authorized official.

NPPES Registry Identity

NPI1093019150
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameSPRINGFIELD MEDICAL LLC
Location Address36351 N GANTZEL RD STE 127San Tan Valley, AZ 85140-7329
Mailing Address36351 N Gantzel Rd Ste 127San Tan Valley, AZ 85140-7329 · (602) 734-5509 · Fax (877) 281-3385
Phone(602) 734-5509
Fax(877) 281-3385
Organization SubpartNo
Authorized OfficialOladiji G VaughanOwner · (602) 734-5509
Enumeration DateJanuary 4, 2011
Last NPPES UpdateJuly 25, 2023
NPPES CertifiedJuly 25, 2023
✔ NPI 1093019150 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in AZ · 40162
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 ListedHospitalistTaxonomy 208M00000X · License 40162 (AZ)
36351 N GANTZEL RD STE 127, San Tan Valley, AZ 85140
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Other Names 1

Doing Business AsSpringfield Pediatrics

Other Identifiers 2

Medicaid358032AZ
Medicaid584197AZ

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

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Springfield Pediatrics is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Springfield Pediatrics, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Oladiji Vaughan, MD
Pediatric Medicine
NPI 1043498520
36351 N GANTZEL RD STE 127
San Tan Valley, AZ 85140
(480) 336-2815
✔ PECOSSame address
Andrea Zander
Nurse Practitioner
NPI 1144913963
36351 N GANTZEL RD STE 127-128
San Tan Valley, AZ 85140
(480) 336-2815
✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 03D2042356

Springfield Medical, LLC · San Tan Valley, AZ
Active · expires Jun 10, 2028
CLIA Number03D2042356
Laboratory TypePractitioner Other
Certificate Effective DateJune 11, 2026
Certificate Expiration DateJune 10, 2028
Laboratory DirectorOladiji G. Vaughan
Laboratory Phone(602) 734-5509
Laboratory LocationSpringfield Medical, LLC36351 N Gantzel Rd Ste 127, San Tan Valley, AZ 85140
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Springfield Medical LLC's NPI number?

The NPI number for Springfield Medical LLC is 1093019150. It was assigned to this organization in the NPPES registry on January 4, 2011. The provider is doing business as Springfield Pediatrics.

Where is Springfield Medical LLC located?

Springfield Medical LLC is located at 36351 N Gantzel Rd Ste 127, San Tan Valley, AZ 85140. The listed phone number is (602) 734-5509.

What is Springfield Medical LLC's specialty?

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

Is Springfield Medical LLC enrolled in Medicare?

Yes. Springfield Medical LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Springfield Medical LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Springfield Medical LLC, in Nurse Practitioner and Pediatric Medicine. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Springfield Medical LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D2042356) is associated with this NPI, valid through June 10, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Springfield Medical LLC accept?

Health plans from Ambetter Health and Ambetter from Arizona Complete Health list Springfield Medical LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Springfield Medical LLC was last updated on July 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.