BANNER -- UNIVERSITY MEDICAL CENTER PHOENIX CAMPUS INTERNAL MEDICINE
NPI 1124071162
Clinic/Center - Multi-Specialty in Phoenix, AZ
NPI Status: Active since May 19, 2006
Contact Information
1300 N 12TH ST
#610
PHOENIX, AZ
ZIP 85006
Phone: (602) 239-4161
Fax: (602) 239-4233
- Organization
- Clinic/Center
- Multi-Specialty
- CLIA Number: 03D0526278
- CLIA Cert. Type: Ancillary Testing Site in Health Care Center
- CLIA Exp. Date: 11-03-2026
About BANNER -- UNIVERSITY MEDICAL CENTER PHOENIX CAMPUS INTERNAL MEDICINE
This page provides the complete NPI Profile along with additional information for Banner -- University Medical Center Phoenix Campus Internal Medicine, a provider established in Phoenix, Arizona operating as a Clinic/center, focusing in multi-specialty . The healthcare provider is registered in the NPI registry with number 1124071162 assigned on May 2006. The practitioner's primary taxonomy code is 261QM1300X. The provider is registered as an organization and their NPI record was last updated 11 years ago. The authorized official of this NPI record is Dennis E Dahlen (Sr Vice President - Finance)
- NPI
- 1124071162
- Provider Name
- BANNER -- UNIVERSITY MEDICAL CENTER PHOENIX CAMPUS INTERNAL MEDICINE
- Entity Type
- Organization
- Location Address
- 1300 N 12TH ST #610 PHOENIX, AZ 85006
- Location Phone
- (602) 239-4161
- Location Fax
- (602) 239-4233
- Mailing Address
- 1441 N 12TH ST PHOENIX, AZ 85006
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 05-19-2006
- Last Update Date
- 02-26-2015
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Multi-Specialty
- Taxonomy Code
- 261QM1300X
- Type
- Ambulatory Health Care Facilities
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| Z73965 | MEDICARE PIN (08) | AZ | |
| 767858 | MEDICAID (05) | AZ | |
| Z106229 | MEDICARE PIN (08) | AZ | |
| Z106232 | MEDICARE PIN (08) | AZ | |
| Z79775 | MEDICARE PIN (08) | AZ |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 03D0526278
- Facility Type
- Ancillary Testing Site in Health Care Center
- Certificate Effective Date
- November 04, 2024
- Certificate Expiration Date
- November 03, 2026
- Laboratory Director
- DR. SURESH UPPALAPU
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Banner -- University Medical Center Phoenix Campus Internal Medicine on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1124071162, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 48. The final step is to find the difference between that total and the next multiple of ten (50 - 48 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 48 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1124071162, enumerated as an "organization" on May 19, 2006.
The provider is located at 1300 N 12TH ST #610 PHOENIX, AZ 85006 and the phone number is (602) 239-4161.
Clinic/Center with taxonomy code 261QM1300X and a focus in Multi-Specialty.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
