INNOVATIVE PRIMARY CARE OF LAKE HAVASU LLC
NPI 1487314878
Clinic/Center - Primary Care in Lake Havasu City, AZ
About Innovative Primary Care Of Lake Havasu Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
INNOVATIVE PRIMARY CARE OF LAKE HAVASU LLC (NPI 1487314878) is a healthcare organization registered as a primary care in Lake Havasu City, Arizona and active in the NPI registry since December 2021. The organization holds a CLIA Waiver certificate valid through October 19, 2027 and lists Loida L Arquiza, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 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)
Innovative Primary Care Of Lake Havasu Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Innovative Primary Care Of Lake Havasu LLC, which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians, nearest first (2)
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 03D2138594
Innovative Primary Care Of Lake Havasu · Lake Havasu City, AZFrequently 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 Innovative Primary Care Of Lake Havasu LLC's NPI number?
The NPI number for Innovative Primary Care Of Lake Havasu LLC is 1487314878. It was assigned to this organization in the NPPES registry on December 27, 2021.
Where is Innovative Primary Care Of Lake Havasu LLC located?
Innovative Primary Care Of Lake Havasu LLC is located at 1945 Mesquite Ave Ste B, Lake Havasu City, AZ 86403. The listed phone number is (928) 733-6287.
What is Innovative Primary Care Of Lake Havasu LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Innovative Primary Care Of Lake Havasu LLC enrolled in Medicare?
Yes. Innovative Primary Care Of Lake Havasu LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Innovative Primary Care Of Lake Havasu LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Innovative Primary Care Of Lake Havasu 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Innovative Primary Care Of Lake Havasu LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 03D2138594) is associated with this NPI, valid through October 19, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Innovative Primary Care Of Lake Havasu LLC was last updated on December 27, 2021. 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.
# Innovative Primary Care Of Lake Havasu Llc · NPI 1487314878
Primary Care organization in Lake Havasu City, Arizona. Organization record, active in the CMS NPPES registry since December 27, 2021.
## Identity
- **NPI:** 1487314878 (Entity type: Organization)
- **Enumerated:** December 27, 2021
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Also known as:** Innovative Primary Care of Lake Havasu LLC (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Loida Arquiza, OWNER
## Practice location
- **Address:** 1945 MESQUITE AVE STE B, Lake Havasu City, AZ 86403-5889
- **Phone:** (928) 733-6287 · **Fax:** (928) 733-6305
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 27, 2021
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1487314878) · Data from the CMS NPPES public registry.