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ARIZONA ESSENTIAL HOLISTIC CARE
NPI 1497246482
Family Medicine in Glendale, AZ

Active since May 24, 2018CLIA 03D2170075 · Waiver
5700 W OLIVE AVE STE 102, GLENDALE, AZ 85302(623) 738-6062(602) 354-9462 Get Directions Write a Review

NPPES record last updated: November 25, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 25, 2019, Oct 26, 2018, May 24, 2018 (3 updates tracked since 2018).

About Arizona Essential Holistic Care NPPES

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

ARIZONA ESSENTIAL HOLISTIC CARE (NPI 1497246482) is a healthcare organization registered as a family medicine in Glendale, Arizona and active in the NPI registry since May 2018. The organization holds a CLIA Waiver certificate valid through July 31, 2027, maintains a secondary practice location in Glendale, and lists Alodia Banuelos Domingo, Provider/owner, as its authorized official.

NPPES Registry Identity

NPI1497246482
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameARIZONA ESSENTIAL HOLISTIC CARE
Location Address5700 W OLIVE AVE STE 102Glendale, AZ 85302
Mailing Address5700 W Olive Ave Ste 102Glendale, AZ 85302-3147 · (602) 738-6062 · Fax (602) 354-9462
Phone(623) 738-6062
Fax(602) 354-9462
Organization SubpartNo
Authorized OfficialAlodia Banuelos DomingoProvider/owner · (623) 738-6062
Enumeration DateMay 24, 2018
Last NPPES UpdateNovember 25, 20193 updates tracked since enumeration
✔ NPI 1497246482 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in AZ · AP5625
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.
5700 W OLIVE AVE STE 102, Glendale, AZ 85302
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Other Names 2

Doing Business AsArizona Essential Holistic Care
Former Legal Business NameArizona Essential Holistic Care, Llc

Secondary Practice Location 1

Location 17200 W Bell Rd Bldg BGlendale, AZ 85308-8529 · Phone (602) 738-6062

Other Identifiers 1

Other811065660AZ · United Health Care

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)

Arizona Essential Holistic 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 Arizona Essential Holistic Care, which bills Medicare for the services this clinician delivers.

Clinician (1)

Alodia Domingo, NP
Nurse Practitioner
NPI 1043635162
5700 W OLIVE AVE STE 102
Glendale, AZ 85302
(623) 738-6062
✔ PECOS✔ Accepts MedicareSame address

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 03D2170075

Arizona Essential Holistic Care, LLC · Glendale, AZ
Active · expires Jul 31, 2027
CLIA Number03D2170075
Laboratory TypePhysician Office
Certificate Effective DateAugust 1, 2025
Certificate Expiration DateJuly 31, 2027
Laboratory DirectorAlodia Domingo
Laboratory Phone(623) 738-6062
Laboratory LocationArizona Essential Holistic Care, LLC5700 W Olive Ave Ste 102, Glendale, AZ 85302
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only 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 Arizona Essential Holistic Care's NPI number?

The NPI number for Arizona Essential Holistic Care is 1497246482. It was assigned to this organization in the NPPES registry on May 24, 2018. The provider was formerly known as Arizona Essential Holistic Care, LLC.

Where is Arizona Essential Holistic Care located?

Arizona Essential Holistic Care is located at 5700 W Olive Ave Ste 102, Glendale, AZ 85302. The listed phone number is (623) 738-6062.

What is Arizona Essential Holistic Care's specialty?

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

Is Arizona Essential Holistic Care enrolled in Medicare?

Yes. Arizona Essential Holistic Care is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Arizona Essential Holistic Care?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Arizona Essential Holistic Care. 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 Arizona Essential Holistic Care hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D2170075) is associated with this NPI, valid through July 31, 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 Arizona Essential Holistic Care was last updated on November 25, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.