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BROADWAY EAST INTERNISTS
NPI 1609523976
Clinic/Center in Mesa, AZ

Active since March 07, 2022CLIA 03D0529202 · Waiver
7525 E BROADWAY RD STE 2, MESA, AZ 85208(480) 981-9800 Get Directions Write a Review

NPPES record last updated: March 7, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Broadway East Internists NPPES

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

BROADWAY EAST INTERNISTS (NPI 1609523976) is a healthcare organization registered as a clinic/center in Mesa, Arizona and active in the NPI registry since March 2022. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Robert Tully, Provider/owner, as its authorized official.

NPPES Registry Identity

NPI1609523976
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameBROADWAY EAST INTERNISTS
Location Address7525 E BROADWAY RD STE 2Mesa, AZ 85208-1154
Mailing Address7525 E Broadway Rd Ste 2Mesa, AZ 85208-1154 · (480) 981-9800
Phone(480) 981-9800
Organization SubpartNo
Authorized OfficialRobert TullyProvider/owner · (480) 981-9800
Enumeration DateMarch 7, 2022
NPPES CertifiedMarch 7, 2022
✔ NPI 1609523976 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
7525 E BROADWAY RD STE 2, Mesa, AZ 85208
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Other Names 1

Doing Business AsBroadway East Internists

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 03D0529202

Broadway East Internists · Mesa, AZ
Active · expires Aug 31, 2026
CLIA Number03D0529202
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorRobert P. Tully, MD
Laboratory Phone(480) 981-9800
Laboratory LocationBroadway East Internists7525 E Broadway Rd Suite 2, Mesa, AZ 85208
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. GWENDA K HATCHER NP
Nurse Practitioner
7525 E BROADWAY RD STE 2
MESA, AZ 85208
Maricopa County (480) 981-9800

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 Broadway East Internists's NPI number?

The NPI number for Broadway East Internists is 1609523976. It was assigned to this organization in the NPPES registry on March 7, 2022.

Where is Broadway East Internists located?

Broadway East Internists is located at 7525 E Broadway Rd Ste 2, Mesa, AZ 85208. The listed phone number is (480) 981-9800.

What is Broadway East Internists's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Does Broadway East Internists hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D0529202) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Broadway East Internists was last updated on March 7, 2022. 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.