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PRIMEHEALTH 360 INC
NPI 1184269177
Family Medicine in La Quinta, CA

Active since November 13, 2019CLIA 05D2203027 · Waiver
79440 CORPORATE CENTER DR STE 111A, LA QUINTA, CA 92253(760) 444-1422 Get Directions Write a Review

NPPES record last updated: September 28, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 28, 2020, Nov 13, 2019 (2 updates tracked since 2019).

About Primehealth 360 Inc NPPES

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

PRIMEHEALTH 360 INC (NPI 1184269177) is a healthcare organization registered as a family medicine in La Quinta, California and active in the NPI registry since November 2019. The organization holds a CLIA Waiver certificate valid through December 1, 2026 and lists Nina K Maw Maw, Owner, as its authorized official.

NPPES Registry Identity

NPI1184269177
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePRIMEHEALTH 360 INC
Location Address79440 CORPORATE CENTER DR STE 111ALa Quinta, CA 92253-7243
Mailing Address79440 Corporate Center Dr Ste 111aLa Quinta, CA 92253-7243 · (760) 444-1422
Phone(760) 444-1422
Organization SubpartNo
Authorized OfficialNina K Maw MawOwner · (760) 444-1422
Enumeration DateNovember 13, 2019
Last NPPES UpdateSeptember 28, 20202 updates tracked since enumeration
NPPES CertifiedSeptember 28, 2020
✔ NPI 1184269177 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
79440 CORPORATE CENTER DR STE 111A, La Quinta, CA 92253
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Primehealth 360 Inc 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 Primehealth 360 Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Nina Maw Maw, M.D.
Family Practice
NPI 1407851777
35900 BOB HOPE DR STE 230
Rancho Mirage, CA 92270
(760) 778-7147
✔ PECOS✔ Accepts Medicare9.1 mi

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 05D2203027

Prime Health 360 · La Quinta, CA
Active · expires Dec 1, 2026
CLIA Number05D2203027
Laboratory TypePhysician Office
Certificate Effective DateDecember 2, 2024
Certificate Expiration DateDecember 1, 2026
Laboratory DirectorNina K. Maw Maw
Laboratory Phone(940) 444-1422
Laboratory LocationPrime Health 36079440 Corporate Center Drive Ste 111A, La Quinta, CA 92253
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

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 Primehealth 360 Inc's NPI number?

The NPI number for Primehealth 360 Inc is 1184269177. It was assigned to this organization in the NPPES registry on November 13, 2019.

Where is Primehealth 360 Inc located?

Primehealth 360 Inc is located at 79440 Corporate Center Dr Ste 111A, La Quinta, CA 92253. The listed phone number is (760) 444-1422.

What is Primehealth 360 Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Primehealth 360 Inc enrolled in Medicare?

Yes. Primehealth 360 Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Primehealth 360 Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Primehealth 360 Inc. 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.

Does Primehealth 360 Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2203027) is associated with this NPI, valid through December 1, 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 Primehealth 360 Inc was last updated on September 28, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.