BANNER PHYSICIAN SUPER SPECIALISTS ARIZONA LLC
NPI 1396014403
Clinic/Center - Multi-Specialty in San Tan Valley, AZ
NPI Status: Active since December 19, 2011
Contact Information
37100 N GANTZEL RD STE 214
SAN TAN VALLEY, AZ
ZIP 85140
Phone: (480) 412-9400
- Organization
- Clinic/Center
- Multi-Specialty
- Accepts Insurance
- CLIA Number: 03D2211681
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 01-28-2027
About BANNER PHYSICIAN SUPER SPECIALISTS ARIZONA LLC
This page provides the complete NPI Profile along with additional information for Banner Physician Super Specialists Arizona Llc, a provider established in San Tan Valley, Arizona operating as a Clinic/center, focusing in multi-specialty . The healthcare provider is registered in the NPI registry with number 1396014403 assigned on December 2011. The practitioner's primary taxonomy code is 261QM1300X. The provider is registered as an organization and their NPI record was last updated April 2026. The authorized official of this NPI record is Shiva Birdi (Ceo)
- NPI
- 1396014403
- Provider Name
- BANNER PHYSICIAN SUPER SPECIALISTS ARIZONA LLC
- Entity Type
- Organization
- Location Address
- 37100 N GANTZEL RD STE 214 SAN TAN VALLEY, AZ 85140
- Location Phone
- (480) 412-9400
- Mailing Address
- 2901 N CENTRAL AVE STE 160 PHOENIX, AZ 85012
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 12-19-2011
- Last Update Date
- 04-16-2026
- Code Navigator
Location Map
Secondary Locations
- 17900 N Porter Rd
Maricopa, AZ 85138
(520) 233-2500 - 1811 E McMurray Blvd
Casa Grande, AZ 85122
(520) 374-6530 - 1760 E Florence Blvd Ste 100
Casa Grande, AZ 85122
(520) 374-6505 - 37000 N Gantzel Rd
Queen Creek, AZ 85140
(480) 397-4000 - 2050 W Southern Ave
Apache Junction, AZ 85120
(480) 733-3300
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:
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
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
- 03D2211681
- Facility Type
- Physician Office
- Certificate Effective Date
- January 29, 2025
- Certificate Expiration Date
- January 28, 2027
- Laboratory Director
- AYAH Y. ELMAGHRABI
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Banner Physician Super Specialists Arizona Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for BANNER PHYSICIAN SUPER SPECIALISTS ARIZONA LLC
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
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 1396014403, we treat the final digit (3) 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 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).
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 57 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1396014403, enumerated as an "organization" on December 19, 2011.
The provider is located at 37100 N GANTZEL RD STE 214 SAN TAN VALLEY, AZ 85140 and the phone number is (480) 412-9400.
Clinic/Center with taxonomy code 261QM1300X and a focus in Multi-Specialty.
The provider might be accepting Accepts: Ambetter from Arizona Complete Health. Please consult your insurance carrier or call the provider to verify.
