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PRIME MEDICAL GROUP, LLC
NPI 1336679414
Family Medicine in Gilbert, AZ

Active since June 12, 2017CLIA 03D0952643 · Microscopy
652 E WARNER RD STE 107, GILBERT, AZ 85296(480) 539-8680(480) 539-1763 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 21, 2022, Jun 12, 2017 (2 updates tracked since 2017).

About Prime Medical Group, Llc NPPES

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

PRIME MEDICAL GROUP, LLC (NPI 1336679414) is a healthcare organization registered as a family medicine in Gilbert, Arizona and active in the NPI registry since June 2017. The organization holds a CLIA Microscopy certificate valid through December 7, 2026 and lists Andria M Keeble, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1336679414
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePRIME MEDICAL GROUP, LLC
Location Address652 E WARNER RD STE 107Gilbert, AZ 85296-3073
Mailing Address652 E Warner Rd Ste 107Gilbert, AZ 85296-3073 · (480) 539-8680 · Fax (480) 539-1763
Phone(480) 539-8680
Fax(480) 539-1763
Organization SubpartNo
Authorized OfficialAndria M KeebleOffice Manager · (480) 539-8680
Enumeration DateJune 12, 2017
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1336679414 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.
652 E WARNER RD STE 107, Gilbert, AZ 85296
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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)

Prime Medical Group, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Prime Medical Group, LLC, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 4 within 10 miles. They are listed nearest first.

Clinicians, nearest first (5)

Jaclyn Brown, MD
Family Practice
NPI 1396972444
652 E. WARNER RD. SUITE 107
Gilbert, AZ 85296
(480) 539-8680
✔ PECOS✔ Accepts MedicareSame address
Sunildat Maheshwari, M.D.
Family Practice
NPI 1417153164
652 E WARNER RD SUITE 107
Gilbert, AZ 85296
(480) 539-8680
✔ PECOS✔ Accepts MedicareSame address
Mark Schlotterback, M.D.
Family Practice
NPI 1861449944
652 E WARNER RD SUITE 107
Gilbert, AZ 85296
(480) 539-8680
✔ PECOS✔ Accepts MedicareSame address
Neerja Sethi, NP
Nurse Practitioner
NPI 1649390709
459 N GILBERT RD SUITE D-160
Gilbert, AZ 85234
(480) 539-8680
✔ PECOS✔ Accepts Medicare1.8 mi
Sharon Luma, FNP
Nurse Practitioner
NPI 1083298160
3501 N SCOTTSDALE RD STE 334
Scottsdale, AZ 85251
(480) 941-4845
✔ PECOS✔ Accepts Medicare14 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 for Provider-Performed Microscopy Procedures (PPMP) 03D0952643

Prime Medical Group · Gilbert, AZ
Active · expires Dec 7, 2026
CLIA Number03D0952643
Laboratory TypePhysician Office
Certificate Effective DateDecember 8, 2024
Certificate Expiration DateDecember 7, 2026
Laboratory DirectorMark Schlotterback
Laboratory Phone(480) 539-8680
Laboratory LocationPrime Medical Group652 E Warner Rd, Ste 107, Gilbert, AZ 85296
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform 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 Prime Medical Group, LLC's NPI number?

The NPI number for Prime Medical Group, LLC is 1336679414. It was assigned to this organization in the NPPES registry on June 12, 2017.

Where is Prime Medical Group, LLC located?

Prime Medical Group, LLC is located at 652 E Warner Rd Ste 107, Gilbert, AZ 85296. The listed phone number is (480) 539-8680.

What is Prime Medical Group, LLC's specialty?

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

Is Prime Medical Group, LLC enrolled in Medicare?

Yes. Prime Medical Group, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Prime Medical Group, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Prime Medical Group, 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. The largest specialties are Family Practice (3) and Nurse Practitioner (2). Of these, 3 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Prime Medical Group, LLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 03D0952643) is associated with this NPI, valid through December 7, 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 Prime Medical Group, LLC was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.