SOUTHERN ARIZONA PODIATRY
NPI 1104691773
Podiatrist - Foot & Ankle Surgery in Green Valley, AZ
About Southern Arizona Podiatry NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTHERN ARIZONA PODIATRY (NPI 1104691773) is a healthcare organization registered as a foot & ankle surgery in Green Valley, Arizona and active in the NPI registry since November 2023. The organization lists Steven Gillespie, Podiatrist, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Southern Arizona Podiatry is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Southern Arizona Podiatry, which bills Medicare for the services this clinician delivers.
Clinician (1)
Green Valley, AZ 85614
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Southern Arizona Podiatry LLC's NPI number?
The NPI number for Southern Arizona Podiatry LLC is 1104691773. It was assigned to this organization in the NPPES registry on November 23, 2023. The provider is doing business as Southern Arizona Podiatry.
Where is Southern Arizona Podiatry LLC located?
Southern Arizona Podiatry LLC is located at 1055 N La Canada Dr Ste 135, Green Valley, AZ 85614. The listed phone number is (801) 310-5651.
What is Southern Arizona Podiatry LLC's specialty?
The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.
Is Southern Arizona Podiatry LLC enrolled in Medicare?
Yes. Southern Arizona Podiatry LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Southern Arizona Podiatry LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Podiatry) reassigns their Medicare billing to Southern Arizona Podiatry LLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Southern Arizona Podiatry LLC was last updated on March 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Southern Arizona Podiatry · NPI 1104691773
Foot & Ankle Surgery organization in Green Valley, Arizona. Organization record, active in the CMS NPPES registry since November 23, 2023.
## Identity
- **NPI:** 1104691773 (Entity type: Organization)
- **Enumerated:** November 23, 2023
- **Primary specialty:** Podiatrist - Foot & Ankle Surgery · taxonomy 213ES0103X
- **Legal business name:** Southern Arizona Podiatry Llc
- **Organization subpart:** No
- **Authorized official:** Steven Gillespie, PODIATRIST
## Practice location
- **Address:** 1055 N LA CANADA DR STE 135, Green Valley, AZ 85614-3700
- **Phone:** (801) 310-5651
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Podiatry) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 8, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1104691773) · Data from the CMS NPPES public registry.