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BANNER PEORIA SURGERY CENTER LLC
NPI 1104341353
Clinic/Center - Ambulatory Surgical in Peoria, AZ

Active since August 09, 2017CLIA 03D2136728 · Waiver
13640 N PLAZA DEL RIO BLVD STE 135, PEORIA, AZ 85381(623) 234-4766(602) 801-3657 Get Directions Write a Review

NPPES record last updated: July 26, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 26, 2019, Aug 9, 2017 (2 updates tracked since 2017).

About Banner Peoria Surgery Center Llc NPPES

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

BANNER PEORIA SURGERY CENTER LLC (NPI 1104341353) is a healthcare organization registered as an ambulatory surgical in Peoria, Arizona and active in the NPI registry since August 2017. The organization holds a CLIA Waiver certificate valid through September 13, 2027 and lists Matthew Cox, Sr Vp Finance, as its authorized official.

NPPES Registry Identity

NPI1104341353
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameBANNER PEORIA SURGERY CENTER LLC
Location Address13640 N PLAZA DEL RIO BLVD STE 135Peoria, AZ 85381-4846
Mailing Address2901 N Central Ave Ste 160Phoenix, AZ 85012-2702
Phone(623) 234-4766
Fax(602) 801-3657
Organization SubpartYesParent: Banner Health
Authorized OfficialMatthew CoxSr Vp Finance · (602) 747-4000
Enumeration DateAugust 9, 2017
Last NPPES UpdateJuly 26, 20192 updates tracked since enumeration
✔ NPI 1104341353 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
13640 N PLAZA DEL RIO BLVD STE 135, Peoria, AZ 85381
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona, Oscar Health Plan, Inc..Insurance ›

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 03D2136728

Banner Peoria Surgery Center LLC · Peoria, AZ
Active · expires Sep 13, 2027
CLIA Number03D2136728
Laboratory TypeSurgery Center
Certificate Effective DateSeptember 14, 2025
Certificate Expiration DateSeptember 13, 2027
Laboratory DirectorMarc Brandon
Laboratory Phone(623) 876-3943
Laboratory LocationBanner Peoria Surgery Center LLC13640 N Plaza Del Rio Blvd Ste 135, Peoria, AZ 85381
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
248 services246 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
181 services180 patients
Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
158 services154 patients
Colorectal cancer screening; colonoscopy on individual at high risk G0105
Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.
100 services100 patients
Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121
Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.
27 services27 patients
Removal of bone from lower spine for decompression of nerve tissue using imaging guidance, accessed through the skin 0275T
This procedure involves removing a small portion of bone from your lower spine. The goal is to relieve pressure on your nerve tissue, improving comfort and mobility. It is done through the skin using imaging technology to ensure precision and safety.
23 services23 patients

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 Banner Peoria Surgery Center LLC's NPI number?

The NPI number for Banner Peoria Surgery Center LLC is 1104341353. It was assigned to this organization in the NPPES registry on August 9, 2017.

Where is Banner Peoria Surgery Center LLC located?

Banner Peoria Surgery Center LLC is located at 13640 N Plaza Del Rio Blvd Ste 135, Peoria, AZ 85381. The listed phone number is (623) 234-4766.

What is Banner Peoria Surgery Center LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Does Banner Peoria Surgery Center LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D2136728) is associated with this NPI, valid through September 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Banner Peoria Surgery Center LLC accept?

Health plans from Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona and Oscar Health Plan, Inc. list Banner Peoria Surgery Center 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 Banner Peoria Surgery Center LLC was last updated on July 26, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.