CENTERWELL SENIOR PRIMARY CARE AZ PC - NPI 1699582106 - Internal Medicine in Surprise, AZ

Q: What is Centerwell Senior Primary Care Az PC's NPI number?

The NPI number for Centerwell Senior Primary Care Az PC is 1699582106. It was assigned to this organization in the NPPES registry on December 17, 2024. The provider is doing business as CenterWell Senior Primary Care-Surprise.

Q: What is Centerwell Senior Primary Care Az PC's specialty?

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

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About Centerwell Senior Primary Care Az Pc NPPES

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

CENTERWELL SENIOR PRIMARY CARE AZ PC (NPI 1699582106), doing business as Centerwell Senior Primary Care-surprise, is a healthcare organization registered as an internal medicine in Surprise, Arizona and active in the NPI registry since December 2024. The organization holds a CLIA Waiver certificate valid through July 20, 2027 and lists Angie Martinez, Senior Credentialing Professional, as its authorized official.

NPPES Registry Identity

NPI1699582106

Entity TypeOrganization

Primary Taxonomy207R00000X

Legal Business NameCENTERWELL SENIOR PRIMARY CARE AZ PC

Location Address14273 W GRAND AVE STE 100Surprise, AZ 85374-4361

Mailing Address6101 Blue Lagoon Dr Ste 200Miami, FL 33126-3168 · (407) 447-7120

Phone(623) 428-8189

Fax(623) 207-7917

Organization SubpartYes

Authorized OfficialAngie MartinezSenior Credentialing Professional · (407) 447-7120

Enumeration DateDecember 17, 2024

NPPES CertifiedDecember 17, 2024

✔ NPI 1699582106 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 MedicineTaxonomy 207Q00000X

Also ListedGeneral PracticeTaxonomy 208D00000X

14273 W GRAND AVE STE 100, Surprise, AZ 85374

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Other Names 1

Doing Business AsCenterwell Senior Primary Care-surprise

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

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 03D2327306

Centerwell Senior Primary Care - Surprise · Surprise, AZ

Active · expires Jul 20, 2027

CLIA Number03D2327306

Laboratory TypePhysician Office

Certificate Effective DateJuly 21, 2025

Certificate Expiration DateJuly 20, 2027

Laboratory DirectorErica L. Savage-Jeter

Laboratory Phone(623) 428-8189

Laboratory LocationCenterwell Senior Primary Care - Surprise14273 W Grand Ave Ste 100, Surprise, AZ 85374

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 6

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

SANJAY SARADHI BOMMAKANTI MD

Internal Medicine