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ARCHWELL HEALTH PROFESSIONAL SERVICES OF ARIZONA, LLC
NPI 1558026880
Internal Medicine in Mesa, AZ

Active since November 02, 2021CLIA Certified · 16 labs
4315 E MAIN ST, MESA, AZ 85205(480) 870-7500(480) 906-2173 Get Directions Write a Review

NPPES record last updated: March 11, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 11, 2026, Apr 5, 2023, Oct 24, 2022 and 3 more (6 updates tracked since 2021).

About Archwell Health Professional Services Of Arizona, Llc NPPES

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

ARCHWELL HEALTH PROFESSIONAL SERVICES OF ARIZONA, LLC (NPI 1558026880) is a healthcare organization registered as an internal medicine in Mesa, Arizona and active in the NPI registry since November 2021. The organization holds 16 active CLIA laboratory certificates, maintains 15 additional practice locations, and lists Amy Moddesette, Sr. Director, Managed Care Ops, as its authorized official.

NPPES Registry Identity

NPI1558026880
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameARCHWELL HEALTH PROFESSIONAL SERVICES OF ARIZONA, LLC
Location Address4315 E MAIN STMesa, AZ 85205-8605
Mailing Address102 Woodmont Blvd Ste 600Nashville, TN 37205-5250
Phone(480) 870-7500
Fax(480) 906-2173
Organization SubpartNo
Authorized OfficialAmy ModdesetteSr. Director, Managed Care Ops · (629) 224-1614
Enumeration DateNovember 2, 2021
Last NPPES UpdateMarch 11, 20266 updates tracked since enumeration
NPPES CertifiedMarch 11, 2026
✔ NPI 1558026880 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
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.
Also ListedFamily Medicine · Geriatric MedicineTaxonomy 207QG0300X
Also ListedInternal Medicine · Geriatric MedicineTaxonomy 207RG0300X
4315 E MAIN ST, Mesa, AZ 85205
Open in Google Maps ↗

Secondary Practice Locations 15

Location 14220 W Bethany Home RdPhoenix, AZ 85019-1808 · Phone (623) 281-1258 · Fax (480) 906-2175
Location 2725 W Apache Trl Ste 4Apache Junction, AZ 85120-3963 · Phone (480) 870-7130 · Fax (480) 906-2171
Location 34420 E McDowell RdPhoenix, AZ 85008-4504 · Phone (602) 858-4295 · Fax (480) 906-2177
Location 48913 N 19th AvePhoenix, AZ 85021-4206 · Phone (602) 858-4361 · Fax (480) 906-2176
Location 52940 S 6th AveTucson, AZ 85713-4705 · Phone (520) 613-1001 · Fax (520) 504-6483
Location 65455 E Speedway BlvdTucson, AZ 85712-4923 · Phone (520) 505-8912 · Fax (888) 355-6926
Location 76843 E Main StMesa, AZ 85207-8207 · Phone (480) 870-7300 · Fax (480) 906-2172
Location 81060 E Southern Ave Ste 106Mesa, AZ 85204-5058 · Phone (480) 870-7400 · Fax (480) 906-2174
Location 92265 W Ina RdTucson, AZ 85741-2650 · Phone (520) 702-3637 · Fax (855) 576-4111
Location 1010050 W Bell Rd Ste 35Sun City, AZ 85351-1290 · Phone (623) 281-1130 · Fax (480) 906-2179
Location 115100 E Broadway BlvdTucson, AZ 85711-3762 · Phone (520) 613-3001 · Fax (520) 504-6481
Location 129550 E Golf Links Rd Ste 100Tucson, AZ 85730-1400 · Phone (520) 910-0207 · Fax (855) 576-4748
Location 131740 E Fort Lowell Rd Ste 100Tucson, AZ 85719-2384 · Phone (520) 613-0001 · Fax (520) 504-6482
Location 1417674 N Litchfield RdSurprise, AZ 85374-2478 · Phone (623) 281-3001 · Fax (480) 906-2180
Location 159750 W Peoria Ave Ste 120Peoria, AZ 85345-6108 · Phone (623) 281-1620 · Fax (480) 906-2178

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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)

Archwell Health Professional Services Of Arizona, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

109

Medicare enrollment records show 109 clinicians reassign Medicare billing to Archwell Health Professional Services Of Arizona, LLC, which bills Medicare for the services they deliver. Of these, 7 practice at this address and 17 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 6

Nurse Practitioner42
Family Practice30
Internal Medicine27
Cardiovascular Disease (Cardiology)8
General Practice1
Pediatric Medicine1

Nearest to this location (20)

See all 109
Lisa Fuller, M.D.
Family Practice
NPI 1366567398
4315 E MAIN ST
Mesa, AZ 85205
(480) 870-7500
✔ PECOSSame address
Nasrin Jazayeri, N.P.
Nurse Practitioner
NPI 1083776785
4315 E MAIN ST
Mesa, AZ 85205
(480) 870-7500
✔ PECOS✔ Accepts MedicareSame address
Spencer Scott, DO
Family Practice
NPI 1356034714
4315 E MAIN ST
Mesa, AZ 85205
(480) 870-7500
✔ PECOSSame address
Anna Sokolowski, M.D.
Family Practice
NPI 1598057200
4315 E MAIN ST
Mesa, AZ 85205
(480) 870-7500
✔ PECOSSame address
Francene Warner, M.D.
Internal Medicine
NPI 1932373693
4315 E MAIN ST
Mesa, AZ 85205
(480) 870-7500
✔ PECOSSame address
Michael Herrera, D.O.
Family Practice
NPI 1871610774
4315 E MAIN STREET
Mesa, AZ 85205
(480) 870-7500
✔ PECOSSame address
Iram Khan, M.D.
Internal Medicine
NPI 1740487719
4315 E MAIN ST
Mesa, AZ 85205
(480) 870-7500
✔ PECOS✔ Accepts MedicareSame address
Praseeda Akella, MD
Family Practice
NPI 1396495503
6843 E MAIN ST
Mesa, AZ 85207
(480) 870-7300
✔ PECOS3.2 mi
Matthew Bell, DO
Family Practice
NPI 1073244323
6843 E MAIN ST
Mesa, AZ 85207
(480) 870-7300
✔ PECOS✔ Accepts Medicare3.2 mi
Christopher Labban, D.O.
Family Practice
NPI 1134165848
6843 E MAIN ST
Mesa, AZ 85207
(480) 870-7300
✔ PECOS3.2 mi
Ashley Vallesarmand, MD
Internal Medicine
NPI 1760124002
6843 E MAIN ST
Mesa, AZ 85207
(480) 870-7300
✔ PECOS3.2 mi
Cassidy Pattik, M.D.
Internal Medicine
NPI 1396278719
1060 E SOUTHERN AVE STE 106
Mesa, AZ 85204
(480) 870-7400
✔ PECOS✔ Accepts Medicare4.3 mi
Amy Simmons, FNP-C
Nurse Practitioner
NPI 1366953143
1060 E SOUTHERN AVE STE 106
Mesa, AZ 85204
(480) 870-7400
✔ PECOS4.3 mi
Leigh Costanzo
Family Practice
NPI 1932563392
1060 E SOUTHERN AVE STE 106
Mesa, AZ 85204
(480) 610-7100
✔ PECOS4.3 mi
Cuauhtemoc Gallardo-Prado, M.D.
Family Practice
NPI 1700116605
1060 E SOUTHERN AVE STE 106
Mesa, AZ 85204
(480) 870-7400
✔ PECOS4.3 mi
Monica Reyes, RN
Nurse Practitioner
NPI 1477218600
1060 E SOUTHERN AVE STE 106
Mesa, AZ 85204
(808) 707-4004
✔ PECOS✔ Accepts Medicare4.3 mi
Timothy Bryan, MD
Family Practice
NPI 1831133743
4365 E PECOS RD SUITE 134
Gilbert, AZ 85295
(480) 840-9155
✔ PECOS9.0 mi
Shana Bean, FNP-BC
Nurse Practitioner
NPI 1538709761
725 W APACHE TRL STE 4
Apache Junction, AZ 85120
(480) 870-7130
✔ PECOS11 mi
Sonja Cruz, D.O.
Family Practice
NPI 1558719955
725 W APACHE TRL
Apache Junction, AZ 85120
(480) 870-7130
✔ PECOS11 mi
Deepthi Narala, MD
Internal Medicine
NPI 1811482284
725 W APACHE TRL STE 4
Apache Junction, AZ 85120
(480) 870-7130
✔ PECOS11 mi
See all 109 clinicians

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 16

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 03D2266926

Archwell Health Professional Services Of Arizona LLC Dba Archwell Health - South Tucson · Tucson, AZ
Active · expires Aug 16, 2028
CLIA Number03D2266926
Laboratory TypePhysician Office
Certificate Effective DateAugust 17, 2026
Certificate Expiration DateAugust 16, 2028
Laboratory DirectorDonald J. Goddard
Laboratory Phone(520) 613-1001
Laboratory LocationArchwell Health Professional Services Of Arizona LLC Dba Archwell Health - South Tucson2940 S 6th Ave, Tucson, AZ 85713
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 03D2266929

Archwell Health Professional Services Of Arizona LLC Dba Archwell Health - Peoria · Peoria, AZ
Active · expires Aug 16, 2028
CLIA Number03D2266929
Laboratory TypePhysician Office
Certificate Effective DateAugust 17, 2026
Certificate Expiration DateAugust 16, 2028
Laboratory DirectorDonald J. Goddard
Laboratory Phone(623) 281-1620
Laboratory LocationArchwell Health Professional Services Of Arizona LLC Dba Archwell Health - Peoria9750 W Peoria Ave, Peoria, AZ 85345
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 03D2266930

Archwell Health Professional Services Of Arizona LLC Dba Archwell Health - North Campbell · Tucson, AZ
Active · expires Aug 16, 2028
CLIA Number03D2266930
Laboratory TypePhysician Office
Certificate Effective DateAugust 17, 2026
Certificate Expiration DateAugust 16, 2028
Laboratory DirectorDonald J. Goddard
Laboratory Phone(520) 613-0001
Laboratory LocationArchwell Health Professional Services Of Arizona LLC Dba Archwell Health - North Campbell1740 E Fort Lowell Rd Ste 100, Tucson, AZ 85719
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 03D2266932

Archwell Health Professional Services Of Arizona LLC Dba Archwell Health - East Tucson · Tucson, AZ
Active · expires Aug 16, 2028
CLIA Number03D2266932
Laboratory TypePhysician Office
Certificate Effective DateAugust 17, 2026
Certificate Expiration DateAugust 16, 2028
Laboratory DirectorDonald J. Goddard
Laboratory Phone(520) 613-3001
Laboratory LocationArchwell Health Professional Services Of Arizona LLC Dba Archwell Health - East Tucson5100 E Broadway, Tucson, AZ 85711
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 03D2266719

Archwell Health Professional Services Of Arizona LLC Dba Archwell Health - Sun City · Sun City, AZ
Active · expires Aug 14, 2028
CLIA Number03D2266719
Laboratory TypePhysician Office
Certificate Effective DateAugust 15, 2026
Certificate Expiration DateAugust 14, 2028
Laboratory DirectorDonald J. Goddard
Laboratory Phone(623) 281-1130
Laboratory LocationArchwell Health Professional Services Of Arizona LLC Dba Archwell Health - Sun City10050 W Bell Rd Ste 35, Sun City, AZ 85351
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 03D2266720

Archwell Health Professional Services Of Arizona LLC Dba Archwell Health - Bethany Home · Phoenix, AZ
Active · expires Aug 14, 2028
CLIA Number03D2266720
Laboratory TypePhysician Office
Certificate Effective DateAugust 15, 2026
Certificate Expiration DateAugust 14, 2028
Laboratory DirectorDonald J. Goddard
Laboratory Phone(623) 281-1258
Laboratory LocationArchwell Health Professional Services Of Arizona LLC Dba Archwell Health - Bethany Home4220 W Bethany Home Rd, Phoenix, AZ 85019
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 Archwell Health Professional Services Of Arizona, LLC's NPI number?

The NPI number for Archwell Health Professional Services Of Arizona, LLC is 1558026880. It was assigned to this organization in the NPPES registry on November 2, 2021.

Where is Archwell Health Professional Services Of Arizona, LLC located?

Archwell Health Professional Services Of Arizona, LLC is located at 4315 E Main St, Mesa, AZ 85205. The listed phone number is (480) 870-7500.

What is Archwell Health Professional Services Of Arizona, LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Archwell Health Professional Services Of Arizona, LLC enrolled in Medicare?

Yes. Archwell Health Professional Services Of Arizona, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Archwell Health Professional Services Of Arizona, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 109 clinicians in 6 Medicare specialties reassign their Medicare billing to Archwell Health Professional Services Of Arizona, 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. The largest specialties are Nurse Practitioner (42), Family Practice (30) and Internal Medicine (27). Of these, 7 practice at this address and 17 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Archwell Health Professional Services Of Arizona, LLC hold CLIA laboratory certificates?

Yes. 16 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Archwell Health Professional Services Of Arizona, LLC was last updated on March 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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.