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PARADISE VALLEY HEALTH CLINIC LLC
NPI 1710715305
Nurse Practitioner - Family in Phoenix, AZ

Active since July 24, 2024
2990 E NORTHERN AVE STE D107, PHOENIX, AZ 85028(480) 725-7106(480) 903-5166 Get Directions Write a Review

NPPES record last updated: August 28, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Paradise Valley Health Clinic Llc NPPES

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

PARADISE VALLEY HEALTH CLINIC LLC (NPI 1710715305) is a healthcare organization registered as a family in Phoenix, Arizona and active in the NPI registry since July 2024. The organization lists Hermine Nazikian, Np And Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1710715305
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NamePARADISE VALLEY HEALTH CLINIC LLC
Location Address2990 E NORTHERN AVE STE D107Phoenix, AZ 85028-4840
Mailing Address2990 E Northern Ave Ste D107Phoenix, AZ 85028-4840 · (480) 725-7106 · Fax (480) 903-5166
Phone(480) 725-7106
Fax(480) 903-5166
Organization SubpartNo
Authorized OfficialHermine NazikianNp And Practice Manager · (480) 725-7106
Enumeration DateJuly 24, 2024
Last NPPES UpdateAugust 28, 2024
NPPES CertifiedAugust 28, 2024
✔ NPI 1710715305 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
2990 E NORTHERN AVE STE D107, Phoenix, AZ 85028
Open in Google Maps ↗

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)

Paradise Valley Health Clinic Llc 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 Paradise Valley Health Clinic LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Hermine Nazikian, APRN
Nurse Practitioner
NPI 1821718453
2990 E NORTHERN AVE STE D107
Phoenix, AZ 85028
(480) 725-7106
✔ 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 03D2310956

Paradise Valley Health Clinic LLC · Phoenix, AZ
Expired · Sep 12, 2026
CLIA Number03D2310956
Laboratory TypePractitioner Other
Certificate Effective DateSeptember 13, 2024
Certificate Expiration DateSeptember 12, 2026
Laboratory DirectorHemine Nazikan
Laboratory Phone(480) 725-7106
Laboratory LocationParadise Valley Health Clinic LLC2990 E Northern Ave Ste D-107, Phoenix, AZ 85028
CLIA data matches this NPI record on: 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 Paradise Valley Health Clinic LLC's NPI number?

The NPI number for Paradise Valley Health Clinic LLC is 1710715305. It was assigned to this organization in the NPPES registry on July 24, 2024.

Where is Paradise Valley Health Clinic LLC located?

Paradise Valley Health Clinic LLC is located at 2990 E Northern Ave Ste D107, Phoenix, AZ 85028. The listed phone number is (480) 725-7106.

What is Paradise Valley Health Clinic LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Paradise Valley Health Clinic LLC enrolled in Medicare?

Yes. Paradise Valley Health Clinic LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Paradise Valley Health Clinic LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Paradise Valley Health Clinic 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Paradise Valley Health Clinic LLC was last updated on August 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.