AZMOBILEMD
NPI 1689126971
Internal Medicine - Geriatric Medicine in Anthem, AZ

Active since November 02, 2016CLIA 03D2121095 · Waiver
39506 N DAISY MOUNTAIN DR STE 122-627, ANTHEM, AZ 85086(623) 218-4171(623) 321-1917 Get Directions Write a Review

NPPES record last updated: May 6, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 6, 2022, Jan 13, 2020, Jan 3, 2020 and 2 more (5 updates tracked since 2016).

About Azmobilemd NPPES

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

AZMOBILEMD (NPI 1689126971) is a healthcare organization registered as a geriatric medicine in Anthem, Arizona and active in the NPI registry since November 2016. The organization holds a CLIA Waiver certificate valid through October 30, 2026 and lists Sam Ile, Ceo, as its authorized official.

NPPES Registry Identity

NPI1689126971
Entity TypeOrganization
Primary Taxonomy207RG0300X
Legal Business NameAZMOBILEMD
Location Address39506 N DAISY MOUNTAIN DR STE 122-627Anthem, AZ 85086-6084
Mailing Address39506 N Daisy Mountain Dr Ste 122-627Anthem, AZ 85086-6084 · (623) 218-4171 · Fax (623) 321-1917
Fax(623) 321-1917
Organization SubpartNo
Authorized OfficialSam IleCeo · (623) 218-4171
Enumeration DateNovember 2, 2016
Last NPPES UpdateMay 6, 20225 updates tracked since enumeration
NPPES CertifiedMay 6, 2022
NPI 1689126971 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RG0300X
License Licensed in AZ · 42672
Definition

An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital.

39506 N DAISY MOUNTAIN DR STE 122-627, Anthem, AZ 85086

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

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 03D2121095

Az Mobile MD, LLC · Phoenix, AZ
Active · expires Oct 30, 2026
CLIA Number03D2121095
Laboratory TypeMobile Physicians
Certificate Effective DateOctober 31, 2024
Certificate Expiration DateOctober 30, 2026
Laboratory DirectorNapoleon Recia Bravo
Laboratory Phone(623) 218-4171
Laboratory LocationAz Mobile MD, LLC32819 N 16th Ave, Phoenix, AZ 85085
CLIA data matches this NPI record on: 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 Azmobilemd's NPI number?

The NPI number for Azmobilemd is 1689126971. It was assigned to this organization in the NPPES registry on November 2, 2016.

Where is Azmobilemd located?

Azmobilemd is located at 39506 N Daisy Mountain Dr Ste 122-627, Anthem, AZ 85086. The listed phone number is (623) 218-4171.

What is Azmobilemd's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Geriatric Medicine, with taxonomy code 207RG0300X.

Does Azmobilemd hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D2121095) is associated with this NPI, valid through October 30, 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 Azmobilemd was last updated on May 6, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.