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PREMISE HEALTH OF ARIZONA MEDICAL PC
NPI 1104654052
Clinic/Center - Multi-Specialty in Mesa, AZ

Active since July 23, 2024CLIA 03D2082900 · Waiver
59 S HIBBERT, MESA, AZ 85210(480) 644-9355(480) 644-2288 Get Directions Write a Review

NPPES record last updated: February 2, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 2, 2026, Apr 4, 2025, Jul 23, 2024 (3 updates tracked since 2024).

About Premise Health Of Arizona Medical Pc NPPES

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

PREMISE HEALTH OF ARIZONA MEDICAL PC (NPI 1104654052), doing business as City Of Mesa Health & Wellness Center, is a healthcare organization registered as a multi-specialty in Mesa, Arizona and active in the NPI registry since July 2024. The organization holds a CLIA Waiver certificate valid through August 24, 2026 and lists Edward Schwartz, President, as its authorized official.

NPPES Registry Identity

NPI1104654052
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NamePREMISE HEALTH OF ARIZONA MEDICAL PC
Location Address59 S HIBBERTMesa, AZ 85210-1414
Mailing Address5500 Maryland Way Ste 120Brentwood, TN 37027-4993
Phone(480) 644-9355
Fax(480) 644-2288
Organization SubpartNo
Authorized OfficialEdward SchwartzPresident · (844) 407-7557
Enumeration DateJuly 23, 2024
Last NPPES UpdateFebruary 2, 20263 updates tracked since enumeration
NPPES CertifiedFebruary 2, 2026
✔ NPI 1104654052 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
59 S HIBBERT, Mesa, AZ 85210
Open in Google Maps ↗

Other Names 1

Doing Business AsCity Of Mesa Health & Wellness Center

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 03D2082900

Premise Health Of Arizona Medical, PC · Mesa, AZ
Active · expires Aug 24, 2026
CLIA Number03D2082900
Laboratory TypePhysician Office
Certificate Effective DateAugust 25, 2024
Certificate Expiration DateAugust 24, 2026
Laboratory DirectorAdrian Pinzon
Laboratory Phone(480) 644-9355
Laboratory LocationPremise Health Of Arizona Medical, PC59 S Hibbert, Mesa, AZ 85210
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

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

PACITA TEE OPULENCIA MD
Pediatrics
59 S HIBBERT
MESA, AZ 85210
Maricopa County (480) 344-6226
JAYAKRISHNA PAINENI
Family Medicine
59 S HIBBERT
MESA, AZ 85210
Maricopa County (480) 344-6200
STEPHANIE PEISHAN YU PA-C
Physician Assistant
59 S HIBBERT
MESA, AZ 85210
Maricopa County (480) 344-6200
DR. RENUKA B. NIGAM MD
Pediatrics
59 S HIBBERT
MESA, AZ 85210
Maricopa County (480) 344-6226
JAMIE BOHANNON APRN-RX
Nurse Practitioner (Family)
59 S HIBBERT
MESA, AZ 85210
Maricopa County (480) 344-6200
MICHAEL WAHBAH D.D.S.
Dentist (General Practice)
59 S HIBBERT
MESA, AZ 85210
Maricopa County (602) 344-6209

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 Premise Health Of Arizona Medical PC's NPI number?

The NPI number for Premise Health Of Arizona Medical PC is 1104654052. It was assigned to this organization in the NPPES registry on July 23, 2024. The provider is doing business as City of Mesa Health & Wellness Center.

Where is Premise Health Of Arizona Medical PC located?

Premise Health Of Arizona Medical PC is located at 59 S Hibbert, Mesa, AZ 85210. The listed phone number is (480) 644-9355.

What is Premise Health Of Arizona Medical PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Does Premise Health Of Arizona Medical PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D2082900) is associated with this NPI, valid through August 24, 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 Premise Health Of Arizona Medical PC was last updated on February 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.