SCOTTSDALE PREMIER CARE
NPI 1366218414
Family Medicine in Phoenix, AZ
About Scottsdale Premier Care NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SCOTTSDALE PREMIER CARE (NPI 1366218414) is a healthcare organization registered as a family medicine in Phoenix, Arizona and active in the NPI registry since November 2023. The organization lists Priyanka Costa Hennis, Medical Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Scottsdale Premier Care 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 Scottsdale Premier Care, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Costa Clinic PLLC's NPI number?
The NPI number for Costa Clinic PLLC is 1366218414. It was assigned to this organization in the NPPES registry on November 29, 2023. The provider is doing business as Scottsdale Premier Care.
Where is Costa Clinic PLLC located?
Costa Clinic PLLC is located at 3811 E Bell Rd Ste 106, Phoenix, AZ 85032. The listed phone number is (602) 443-1085.
What is Costa Clinic PLLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Costa Clinic PLLC enrolled in Medicare?
Yes. Costa Clinic PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Costa Clinic PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Costa 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Costa Clinic PLLC was last updated on December 14, 2023. 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.
# Scottsdale Premier Care · NPI 1366218414
Family Medicine organization in Phoenix, Arizona. Organization record, active in the CMS NPPES registry since November 29, 2023.
## Identity
- **NPI:** 1366218414 (Entity type: Organization)
- **Enumerated:** November 29, 2023
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Costa Clinic Pllc
- **Organization subpart:** No
- **Authorized official:** Priyanka Costa Hennis, MEDICAL DIRECTOR
## Practice location
- **Address:** 3811 E BELL RD STE 106, Phoenix, AZ 85032-2158
- **Phone:** (602) 443-1085 · **Fax:** (602) 443-1086
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 14, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1366218414) · Data from the CMS NPPES public registry.