GRAND CANYON MEDICAL CLINIC PLLC
NPI 1164141065
Nurse Practitioner - Family in Yuma, AZ
About Grand Canyon Medical Clinic Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GRAND CANYON MEDICAL CLINIC PLLC (NPI 1164141065) is a healthcare organization registered as a family in Yuma, Arizona and active in the NPI registry since August 2022. The organization holds a CLIA Waiver certificate valid through November 5, 2027 and lists Alex D Galvez, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Grand Canyon Medical Clinic Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Grand Canyon Medical Clinic PLLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.
Clinicians, nearest first (2)
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 03D2293260
Grand Canyon Medical Clinic, Plc · Yuma, 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 Grand Canyon Medical Clinic PLLC's NPI number?
The NPI number for Grand Canyon Medical Clinic PLLC is 1164141065. It was assigned to this organization in the NPPES registry on August 24, 2022.
Where is Grand Canyon Medical Clinic PLLC located?
Grand Canyon Medical Clinic PLLC is located at 1841 W 25th St Ste B, Yuma, AZ 85364. The listed phone number is (928) 503-7246.
What is Grand Canyon Medical Clinic PLLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Grand Canyon Medical Clinic PLLC enrolled in Medicare?
Yes. Grand Canyon Medical Clinic PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Grand Canyon Medical Clinic PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Grand Canyon Medical Clinic PLLC. 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. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Grand Canyon Medical Clinic PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 03D2293260) is associated with this NPI, valid through November 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Grand Canyon Medical Clinic PLLC was last updated on February 20, 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.
# Grand Canyon Medical Clinic Pllc · NPI 1164141065
Family organization in Yuma, Arizona. Organization record, active in the CMS NPPES registry since August 24, 2022.
## Identity
- **NPI:** 1164141065 (Entity type: Organization)
- **Enumerated:** August 24, 2022
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Alex Galvez, OWNER
## Practice location
- **Address:** 1841 W 25TH ST STE B, Yuma, AZ 85364-6931
- **Phone:** (928) 503-7246
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R); 1 practice at this address and 2 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 20, 2024
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1164141065) · Data from the CMS NPPES public registry.