CENTERWELL SENIOR PRIMARY CARE AZ CS PC
NPI 1477418382
Internal Medicine in Surprise, AZ
- Organization
- Internal Medicine
- CLIA Number: 03D2241742
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 10-31-2027
About CENTERWELL SENIOR PRIMARY CARE AZ CS PC
This page provides the complete NPI Profile along with additional information for Centerwell Senior Primary Care Az Cs Pc, an internist established in Surprise, Arizona operating as a Internal Medicine. The healthcare provider is registered in the NPI registry with number 1477418382 assigned on December 2025. The practitioner's primary taxonomy code is 207R00000X. The provider is registered as an organization and their NPI record was last updated one year ago. Centerwell Senior Primary Care Az Cs Pc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Angie Martinez (Senior Credentialing Professional)
- NPI
- 1477418382 Verify this NPI
- Provider Name
- CENTERWELL SENIOR PRIMARY CARE AZ CS PC
- Entity Type
- Organization
- Location Address
- 14749 W MOUNTAIN VIEW BLVD STE 138 SURPRISE, AZ 85374
- Location Phone
- (623) 738-0440
- Location Fax
- (480) 374-8051
- Mailing Address
- 6101 BLUE LAGOON DR STE 200 MIAMI, FL 33126
- Mailing Phone
- (407) 447-7120
- Mailing Fax
- (407) 770-0661
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 12-23-2025
- Last Update Date
- 12-23-2025
- Code Navigator
An internist like Centerwell Senior Primary Care Az Cs Pc is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
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
Internal Medicine
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | |
| 2 | 208D00000X | Allopathic & Osteopathic Physicians | General Practice |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
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
- 03D2241742
- Facility Type
- Physician Office
- Certificate Effective Date
- November 01, 2025
- Certificate Expiration Date
- October 31, 2027
- Laboratory Director
- TRACY WAKEFIELD
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Centerwell Senior Primary Care Az Cs Pc 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.
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Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
SURPRISE, AZ 85374
SURPRISE, AZ 85374
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1477418382, enumerated as an "organization" on December 23, 2025.
The provider is located at 14749 W MOUNTAIN VIEW BLVD STE 138 SURPRISE, AZ 85374 and the phone number is (623) 738-0440.
Internal Medicine with taxonomy code 207R00000X.
