PRISMA COMMUNITY CARE
NPI 1104929504
Nurse Practitioner - Psychiatric/Mental Health in Phoenix, AZ
About Prisma Community Care NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PRISMA COMMUNITY CARE (NPI 1104929504), doing business as Southwest Center, is a healthcare organization registered as a psychiatric/mental health in Phoenix, Arizona and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through June 30, 2028 and lists Casey Simon, Authorized Official, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 6
Other Names 1
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Prisma Community Care is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by February 28, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
16Medicare enrollment records show 16 clinicians reassign Medicare billing to Prisma Community Care, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 11 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 3
Clinicians, nearest first (16)
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 03D1085957
Prisma Community Care · Phoenix, AZFrequently 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 Prisma Community Care's NPI number?
The NPI number for Prisma Community Care is 1104929504. It was assigned to this organization in the NPPES registry on September 7, 2006. The provider is doing business as Southwest Center.
Where is Prisma Community Care located?
Prisma Community Care is located at 1101 N. Central Avenue Suite 200, Phoenix, AZ 85004. The listed phone number is (602) 307-5330.
What is Prisma Community Care's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Prisma Community Care enrolled in Medicare?
Yes. Prisma Community Care is registered in the Medicare PECOS enrollment system.
When is Prisma Community Care's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Arizona, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Prisma Community Care?
According to the CMS Revalidation Reassignment List (October 2026 release), 16 clinicians in 3 Medicare specialties reassign their Medicare billing to Prisma Community Care. 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. The largest specialties are Nurse Practitioner (11), Clinical Social Worker (4) and Mental Health Counselor (1). Of these, 1 practice at this address and 11 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Prisma Community Care hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 03D1085957) is associated with this NPI, valid through June 30, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Prisma Community Care accept?
Health plans from Ambetter from Arizona Complete Health and Blue Cross Blue Shield of Arizona list Prisma Community Care 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 Prisma Community Care was last updated on September 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 49 days 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.
# Prisma Community Care · NPI 1104929504
Psychiatric/Mental Health organization in Phoenix, Arizona. Organization record, active in the CMS NPPES registry since September 7, 2006.
## Identity
- **NPI:** 1104929504 (Entity type: Organization)
- **Enumerated:** September 7, 2006
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Also known as:** Southwest Center (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Casey Simon, AUTHORIZED OFFICIAL
## Practice location
- **Address:** 1101 N. CENTRAL AVENUE, SUITE 200, Phoenix, AZ 85004
- **Phone:** (602) 307-5330 · **Fax:** (602) 307-5021
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** February 28, 2027 (Non-DME Part B, Arizona, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 16 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (11), Clinical Social Worker (4), Mental Health Counselor (1); 1 practice at this address and 11 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 2, 2026
- **Other identifiers:** Medicaid 928418 (AZ)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1104929504) · Data from the CMS NPPES public registry.